Another Single-Item Screening Test?
To increase the likelihood that clinicians will address unhealthy alcohol use with their patients, researchers are pursuing briefer and simpler intervention strategies. Through a web-based survey completed by 3909 college students in North Carolina (36% response rate), researchers examined whether one question ("In a typical week, how many days do you get drunk?") could identify drinkers at risk of injury.
- Of 2488 current (past 30-day) drinkers, 54% got drunk at least once in a typical week.
- In analyses adjusted for potential confounders (e.g., race, current drinking), students who got drunk in a typical week were significantly more likely than those who did not to have
- been injured because of their drinking (odds ratio [OR] 5.0);had a fall requiring treatment (OR 2.2);
- caused or experienced “secondhand” effects of alcohol, such as being taken advantage of sexually because of another’s drinking (OR 2.6) or causing injury to another person that required treatment (OR 2.6).
- Drunkenness was a better indicator of the injury outcomes than was heavy episodic drinking.*
This study did not assess for alcohol use disorders, a significant limitation that precludes recommending the single question as a clinical screening test. But the results are interesting because they suggest that a question about drunkenness might identify college-student drinking with consequences better than a question about heavy drinking on an occasion would. For now, it seems reasonable for clinicians to ask the question when discussing drinking with college students.Richard Saitz, MD, MPH
O'Brien MC, McCoy TP, Champion H, et al. Single question about drunkenness to detect college students at risk for injury. Acad Emerg Med. 2006;13(6):629–636.