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How health-care providers are reducing the risk of alcohol use and injury

Toronto, February 6, 2015

By Evelyne Jhung

Social worker Laurie DeOliveira, who does alcohol screening interventions at St. Michael's
When injured patients with a positive blood alcohol level come to St. Michael’s, a social worker such as Laurie DeOliveira is called in for an alcohol screening intervention. (Photo by Yuri Markarov)

Of the 677 severely injured patients seen by the St. Michael’s trauma team in 2013, 180 of them, or 26.5 per cent, had a positive blood alcohol level.

Each one of them – no matter what the alcohol level was—had an alcohol screening intervention from a social worker.

“There is a clear link between alcohol use – and not necessarily alcoholism – and injury,” said Laurie DeOliveira, a Trauma and Neurosurgery social worker. “In fact, the majority of injuries that include the use of alcohol happen to be at a time when a person used a little more than usual or had an episode of binge drinking.”

Evidence shows that offering a single brief motivational intervention can reduce the risk of future injury by as much as 50 per cent, so in 2007, St. Michael’s began its intervention program.

The intervention generally takes about 20 minutes and consists of providing information to patients about their blood alcohol level upon arrival at St. Michael’s, a questionnaire and advice from a social worker such as DeOliveira, Ingrid Kuran or Leanna McCarney.

“Trauma units are an ideal location for a teachable moment because the patient’s injuries can help motivate behaviour change,” said DeOliveira. “We have a conversation about alcohol use and the impact it has on their lives – socially, financially and personally. I’ll provide some recommendations about quantities consumed and safer drinking practices.”

9. Have you or someone else been injured as a result of your drinking?NoYes, but not in the last year.Yes, during the last year.
Sample question from the alcohol screening intervention questionaire.

Patients who are considered at high risk are offered community resources and encouraged to seek further intervention, such as Alcoholics Anonymous or referral to the Centre for Addiction and Mental Health.

“Overall, patients are quite willing and interested in both the intervention and the community resources,” said DeOliveira. “The hope is to continue to offer the alcohol intervention with the intention of reducing re-admissions, injuries and risk to those who use alcohol.”

Not all who come to St. Michael’s trauma unit qualify for the intervention, such as those who have a well-known alcohol dependency or those whose injuries may be too severe to allow for the intervention.

About St. Michael's Hospital

St. Michael’s Hospital provides compassionate care to all who enter its doors. The hospital also provides outstanding medical education to future health care professionals in 27 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, care of the homeless and global health are among the hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing International Healthcare Education Centre, which make up the Li Ka Shing Knowledge Institute, research and education at St. Michael's Hospital are recognized and make an impact around the world. Founded in 1892, the hospital is fully affiliated with the University of Toronto.