Characteristics and comorbidity of drug and alcohol-related emergency department presentations detected by nursing triage text

Authors

  • Devon Indig,

    Corresponding author
    1. Centre for Health Research in Criminal Justice, Justice Health, Sydney, Australia,
    2. School of Public Health and Community Medicine, University of New South Wales, NSW, Australia,
    Search for more papers by this author
  • Jan Copeland,

    1. National Cannabis Prevention and Information Centre, Sydney, Australia,
    Search for more papers by this author
  • Katherine M. Conigrave,

    1. Drug Health Services, Royal Prince Alfred Hospital, Sydney, Australia,
    2. Sydney Medical School, University of Sydney, Sydney, Australia and
    3. National Drug and Alcohol Research Centre, Sydney, Australia
    Search for more papers by this author
  • Anthony Arcuri

    1. National Cannabis Prevention and Information Centre, Sydney, Australia,
    Search for more papers by this author

Devon Indig, Centre for Health Research in Criminal Justice, Justice Health, Suite 302, Level 2, 152 Bunnerong Road, Eastgardens NSW 2035, Australia. E-mail: devon.indig@justicehealth.nsw.gov.au

ABSTRACT

Introduction  This study used nursing triage text to detect drug- and alcohol-related emergency department (ED) presentations and describe their patient and service delivery characteristics.

Methods  Data were reviewed for all ED presentations from 2004 to 2006 (n = 263 937) from two hospitals in Sydney, Australia. Each record included two nursing triage free-text fields, which were searched for more than 100 drug-related and more than 60 alcohol-related terms. Adjusted odds ratios were used to compare the characteristics of drug and alcohol-related ED presentations with all other ED presentation types.

Results  Just over 5% of ED presentations were identified as alcohol-related and 2% as drug-related. The most prevalent drug-related ED presentations specified were related to amphetamines (18%), heroin (14%), cannabis (14%) and ecstasy (12%), while nearly half (43%) were drug unspecified. Polydrug use was mentioned in 25% of drug-related and 9% of alcohol-related ED presentations, with the highest rate of polydrug use among ecstasy-related (68%) presentations. Drug- and alcohol-related ED presentations were significantly more likely than other ED presentations to have a mental health diagnosis, with the highest rates found among cannabis-related (OR = 7.6) or amphetamine-related (OR = 7.5) presentations.

Conclusion  The ED provides an opportunity for early intervention for patients presenting with comorbid drug and alcohol and mental health problems. Further research is needed to assess the prevalence of drug and alcohol problems in ED patients with mental health problems and to develop effective interventions in that setting.

Ancillary