Whether at home, on the road, or in relationships, people who drink too much are at a higher risk of sustaining injury or causing injury to others. Excessive drinking is the leading risk factor for injury in the United States and the third leading cause of preventable death. The CDC’s Injury Center supports alcohol Screening and Brief Intervention (SBI), a clinical preventive service now provided in many Level I trauma centers. The American College of Surgeons Committee on Trauma (COT) requires Level I trauma centers to have a mechanism to identify patients whose drinking is unhealthy and provide on-the-spot brief counseling. This requirement of screening and brief intervention is an evidence-based two-step process: conducting a screening and implementing brief intervention if the screening is positive for risky alcohol use.
Alcohol SBI is a pragmatic approach to reducing excessive drinking and risky behavior that yields significant results. Trials that used brief counseling sessions for patients who drink too much have decreased the rate of readmission to a trauma center, ED or hospital by up to 50 percent. Studies further demonstrated a significant decrease in the number of binge drinking episodes and drinks consumed per week by patients who received counseling. While alcohol SBI may only begin the help needed for the 4% of the U.S. population that is addicted to alcohol, it’s clear that SBI makes a significant impact with those people who drink too much and are at risk from harm but are not alcohol dependent, an estimated 25 percent of the U.S. population.
Trauma centers are in an ideal position to seize the opportunity when a patient is seeking critical care and is more likely receptive to the SBI message. Many worthy interventions fail because they cannot reach and capture the attention of their target audience. Not so for alcohol SBI, which delivers a targeted message to every patient who screens positive. Although we cannot ensure that every patient will be receptive to the potentially life-saving message being provided in the intervention, SBI has demonstrated remarkable success at very low costs. One study from a CDC-funded injury research center indicated that for each dollar spent on alcohol screening and brief intervention, $3.81 was saved in overall healthcare costs.
To facilitate SBI’s expansion, the Injury Center has developed and posted a new on-line guide to assist trauma staff and health care professionals in developing, implementing and maintaining an alcohol SBI program. The move by the COT to require Level I trauma centers to provide alcohol SBI is a powerful and positive step, yet trauma centers see only a fraction of the total patients treated by healthcare professionals every day. We, therefore, believe that the expansion of alcohol SBI into other health care settings is a necessary next step in our continued efforts to reduce injuries and deaths caused by people who drink in excess. Leadership at every level is required to tackle the enormous public health burden caused by the increase in risky or anti-social behavior by those who drink in excess. The Injury Center applauds its partners, practitioners and people who rise each day to meet this challenge to improve our nation’s public health and safety.