By Alan Mozes
NEW YORK, (Reuters Health) -- Teens who are counseled about alcohol
use in the emergency room while they are being treated for injuries linked to
drinking are much less likely to repeat risky drinking behavior in the future,
according to a new report.
"It's a great opportunity to intervene with young people -- while they are
right in the middle of some undeniably negative consequence related to alcohol,
and they're open to seeing the downside and listening to what you have to say
about it," said study co-author Dr. Suzanne Colby, assistant professor of
psychiatry and human behavior at Brown University School of Medicine in Rhode
Island.
Colby and her team studied 94 teens aged 18 and 19 who were admitted to an
emergency department because of an alcohol-related injury. Half of the teens
were given a handout on drunk driving with a list of treatment centers, as well
as a 40-minute motivational counseling session directly after medical treatment
in which the teens discussed the traumatic event, the pros and cons of drinking,
and their goals for the future. The other half of the group received medical
treatment and was only given the handout. All study participants were
interviewed again within the following 6 months, and Department of Motor Vehicle
data was obtained to assess behavior during the follow-up period.
In an interview with Reuters Health, Colby explained that "young adults
make up the highest risk population of drinkers. For some, just going into an ER
motivates behavior change. But others are going to need more, and by spending
less than an hour with them this counseling can have a big impact, which is
really exciting -- really amazing."
Within 6 months of admission to the emergency department, there was a
similar drop in the amount of alcohol actually consumed by both groups of teens.
However, the investigators found that those who were given counseling were
significantly less likely to have experienced alcohol-related problems --
accumulating 50% fewer alcohol-related injuries, 32% fewer drunk driving
accidents, and about 20% fewer moving violations than those who were not
counseled. The findings are published in the December issue of The Journal of
Consulting and Clinical Psychology.
The results illustrate that for teens, the time of admission to an
emergency department is a "teachable moment," said Colby. "In other settings
where we've tried to talk to kids -- like in a fraternity house -- they are used
to drinking without a lot of negative consequences. They socialize, have a good
time, cut loose... they are only seeing the positive side of drinking, and deny
the negative. In an ER, they can see the negative."
To take advantage of this particular setting, Colby said the research team
included emergency department staff to ensure that the counseling design was
practical. "It's feasible and very realistic for use in any ER -- something that
social workers routinely available in an ER setting could do cheaply, quickly,
and easily."
Referring to future plans to study an expanded age range of 18 to 24 year
olds, Colby suggested that the motivational counseling model they have designed
might eventually become part of standard care practice in emergency departments.
The model could help teens and even older young adults "to change their behavior
and drink in a less risky way" by encouraging them not to drive a car when they
drink, to spread drinks out over a longer period of time, and to change the
social environment in which they drink.
"It's not a cure-all," said Colby, "but if this is the only real chance
you're going to have to talk to these kids, then you're going to have to take
that opportunity, because this is definitely going to help the kids."
