Presented at the Society for Academic Emergency Medicine annual meeting, New York, NY, May 2005; and the Association for Medical Education and Research in Substance Abuse annual meeting, Washington, DC, November 2005.
Integrating Project ASSERT: A Screening, Intervention, and Referral to Treatment Program for Unhealthy Alcohol and Drug Use Into an Urban Emergency Department
Article first published online: 29 JUL 2010
© 2010 by the Society for Academic Emergency Medicine
Academic Emergency Medicine
Volume 17, Issue 8, pages 903–911, August 2010
How to Cite
D’Onofrio, G. and Degutis, L. C. (2010), Integrating Project ASSERT: A Screening, Intervention, and Referral to Treatment Program for Unhealthy Alcohol and Drug Use Into an Urban Emergency Department. Academic Emergency Medicine, 17: 903–911. doi: 10.1111/j.1553-2712.2010.00824.x
This project was funded by the Robert Wood Johnson Foundation “New Haven Fighting Back” Initiative and the Connecticut Department of Mental Health and Addiction Services.
Supervising Editor: Lynne D. Richardson, MD.
- Issue published online: 29 JUL 2010
- Article first published online: 29 JUL 2010
- Received March 2, 2010; revision received April 26, 2010; accepted April 30, 2010.
- substance-related disorders;
- emergency department;
- alcohol drinking
ACADEMIC EMERGENCY MEDICINE 2010; 17:903–911 © 2010 by the Society for Academic Emergency Medicine
Objectives: The objective was to evaluate the effects of Project Alcohol and Substance Abuse Services Education and Referral to Treatment (ASSERT), an emergency department (ED)-based screening, brief intervention, and referral to treatment program for unhealthy alcohol and other drug use.
Methods: Health promotion advocates (HPAs) screened ED patients for alcohol and/or drug problems 7 days a week using questions embedded in a general health questionnaire. Patients with unhealthy drinking and/or drug use received a brief negotiation interview (BNI), with the goal of reducing alcohol/drug use and/or accepting a referral to a specialized treatment facility (STF), depending on severity of use. Patients referred to an STF were followed up at 1 month by phone or contact with the STF to determine referral completion and enrollment into the treatment program.
Results: Over a 5-year period (December 1999 through December 2004), 22,534 adult ED patients were screened. A total of 10,246 (45.5%) reported alcohol consumption in the past 30 days, of whom 5,533 (54%) exceeded the National Institute on Alcohol Abuse and Alcoholism (NIAAA) guidelines for low-risk drinking. Use of at least one illicit drug was reported by 3,530 patients (15.7%). Over one-fourth of screened patients received BNIs (6,266, or 27.8%). Of these, 3,968 (63%) were referred to an STF. Eighty-three percent of patients were followed at 1 month, and 2,159 (65%) had enrolled in a program. Patients who received a direct admission to an STF were 30 times more likely to enroll than those who were indirectly referred (odds ratio = 30.71; 95% confidence interval = 18.48 to 51.04). After 3 years, funding for Project ASSERT was fully incorporated into the ED budget.
Conclusions: Project ASSERT has been successfully integrated into an urban ED. A direct, facilitated referral for patients with alcohol and other drug problems results in a high rate of enrollment in treatment programs.