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Detecting Alcohol Use Disorders in Recently Hospitalized Persons: Results from the National Epidemiologic Survey on Alcohol and Related Conditions

Stewart, Scott H. MD, MS; Miller, Peter M. PhD

Journal of Addiction Medicine: March 2007 - Volume 1 - Issue 1 - pp 40-43
doi: 10.1097/ADM.0b013e31804a3a07
Original Article

Pharmacotherapy combined with medical management, an increasingly viable option for treating alcohol use disorders in health care settings, requires rapid and reliable diagnosis. This study explored a simple screening approach in persons with recent general hospital admission who participated in the National Epidemiologic Survey on Alcohol and Related Conditions reporting hospitalization during the past year (n = 4537). The survey included detailed assessment of alcohol consumption and full diagnostic assessment for alcohol use disorders. The sensitivity and specificity of 1 heavy drinking day question were estimated by using methods appropriate for complex survey data. Results showed that, among recently hospitalized persons consuming any alcohol in the past year, a response of at least 1 heavy drinking day during that time was 86% sensitive and 77% specific for current alcohol use disorders. The item performed better for alcohol dependence than abuse. False-negative screens were associated with older age and less alcohol consumption. Because of its brevity and compatibility with a typical admission history, the heavy drinking day item should be considered for screening current drinkers at the time of hospitalization. However, future research also should validate this screen at the point of care.

From the Department of Psychiatry (SHS, PMM), Center for Drug and Alcohol Programs; Division of General Internal Medicine, Department of Medicine (SHS); Medical University of South Carolina, Charleston, SC.

Received November 30, 2006; revised February 6, 2007; accepted February 7, 2007.

Send correspondence and reprint requests to Dr. Scott H. Stewart, Center for Drug and Alcohol Programs, P.O. Box 250861, 67 President Street, Charleston, SC 29425. e-mail: stewarsh@musc.edu.

This study was supported in part by Career Development Award K23AA014188 from the National Institute on Alcohol Abuse and Alcoholism.

© 2007 American Society of Addiction Medicine