A friend of mine who worked in the ER used to swear up and down that “everyone who comes through our doors is drunk.” Even at my alcoholic worst, I never believed him. It just seemed unfathomable to me. I just figured that, when you’re working in the ER, it probably just seemed that everyone who visited was under the influence. Turns out, he wasn’t far off. While experts actually put that number closer to 50 percent of everyone who visits the ER, there’s an even more staggering statistic about the people stumbling through those hospital doors: a new study claims that “visits of the emergency room for alcohol intoxication have increased more than 50 percent over the past decade,” according to LiveScience. “These visits place a strain on the U.S. emergency care system and represent a public health problem,” the authors argue, calling for better strategies to identify problem drinking before it lands in a hospital bed. It’s a troubling trend that reveals not only a serious burden on hospital resources but our country’s increasing battle with the bottle.
No Signs of Slowing Down
If it’s not troubling enough that more people than ever are checking into the ER thanks to booze, there are no signs that these visits are slowing down, either. The study, conducted by The George Washington University’s Center for Healthcare Innovation and Policy Research, examined alcohol-related visits to US emergency departments between 2001 and 2011. In just 10 years, ER visits spiked by 1.4 million. “Between 2001–2002 and 2010–2011, alcohol-related visits increased from 2,459,748 to 3,856,346,” the study’s authors observed. The study didn’t only focus on whether patients were diagnosed with alcohol intoxication or abuse—it also collected info on patients whose trip to the ER included key phrases like “alcohol-related problems,” “adverse effects of alcohol,” “alcoholism” or “alcohol detoxification.” The study also included cases “in which a patient was injured because he or she was intoxicated.”
The increase in ER visits didn’t go unnoticed by hospitals, either. As the number of patients admitted to the ER increases, so, too, does the time spent in the hospital. In fact, the study’s authors found that the number of hours spent in the hospital doubled during the decade. “The overall length of a stay for alcohol-related ER visits increased by 16 percent, from about 5 hours in 2001 to 2002 to 5.8 hours in 2010 to 2011,” the LiveScience story claimed, pointing out that the increase is partially due to more intensive care. Still, the total amount of alcohol-related hours spent in the U.S. increased to 11.6 million hours in 2011, which represents a mind-blowing increase of 108.5% (yes, you read that right) over 2001. Put another way: the number of alcohol-related visits to the ER is increasing so rapidly that it’s quickly eclipsing every other reason to visit to ER.
“Expensive and Time-Consuming”
The study’s authors suggest there’s another factor for the increased time spent in hospitals: technology. Between 2001 and 2002, the study notes that only 11.5 percent of alcohol-related ER visits involved CT/CAT scans or MRI machines. By 2011, that number had skyrocketed to 38.2 percent of all alcohol-related visits. Otherwise known as “Computerized Tomography Scans,” CT/CAT scans collect multiple X-ray images from different angles to “create cross-sectional images, or slices, of the bones, blood vessels and soft tissues inside your body.” The scans became popular with alcohol-related ER visits because of their ability to quickly screen out other problems, diseases or injuries.
Still, researchers noted that while the scans are helpful in checking for head injuries, they warned that the “expensive and time-consuming” scans also run the risk of being overused in the ER. The LiveScience piece cites a recent study that “found that the percentage of CT scans that actually lead to a diagnosis are declining, meaning that doctors are using CT scans more often but aren’t detecting more health problems.” Furthermore, there’s the ever-present concern that CT-scan radiation increases the risk of cancer.
Beyond CT/MRI scans, researchers also found an increase in the amount of IV fluids being used, which also lengthens the average patient’s stay in the ER. “It’s also common for doctors to allow patients to metabolize the alcohol and show they are sober before being discharged, which can also require a significant amount of time in some cases,” the story said.
Before It Becomes a Problem
The best time to treat alcohol problems isn’t during a hospital stay, experts contend. As the study’s authors note, there’s a real opportunity for health care providers to address problems well before they walk through the doors of an ER. As one author suggested, the Screening, Brief Intervention and Referral to Treatment (SBIRT) tool is one such strategy that helps identify problem drinking and substance abuse early on. Generally used in primary care offices, the SBIRT involves a healthcare professional who “assesses a patient for risky substance use, engages him or her in a short conversation and provides a referral for patients who need additional treatment.”
Fascinatingly, for all the facts, figures, tools and trends surrounding the increasing number of alcohol-related ER visits, the most unsettling part is that no one knows why it’s happening in the first place. It’s equally confounding because, during the exact same time period examined in the study, binge-drinking actually decreased (and continues to decrease) in the US. (That’s not to say binge-drinking still isn’t a $250 billion-per-year hit to the American economy.) And while the reason for the increase is unclear, one thing isn’t: we’re getting closer to solving the mystery. As our research efforts and intervention strategies improve, we’ll be able to see warning signs well before they wind up as vital signs in a hospital room.