Does Alcohol Screening, Brief Intervention, and Referral to Treatment Work for Adolescents Presenting to Emergency Departments?

Many adolescents who present to the emergency department (ED) for injury and other problems have unhealthy alcohol use. To assess the efficacy of alcohol screening, brief intervention, and referral to treatment (SBIRT) in this population, researchers conducted a systematic review of randomized controlled trials of SBIRT for adolescents (age range, 11–21 years) presenting to US EDs.

• Seven randomized controlled trials met inclusion criteria, with the number of participants ranging from 94 to 853.

• Four of the 7 trials found the intervention significantly reduced alcohol use or adverse consequences (but not both) in follow-ups ranging from 3 to 12 months after the ED visit, while 3 found no significant intervention effect on either alcohol use or adverse consequences.

• Five of the 7 trials found a decrease in alcohol use and/or adverse consequences in all study arms, including the control arm.

• The largest intervention effects were seen in the 2 trials that did not include participants younger than 18 years.

Comments:

This systematic review shows the efficacy of alcohol SBIRT for adolescents in the ED is still uncertain, especially for younger adolescents. Further research should assess whether different interventions are needed for different age and risk groups, evaluate different delivery models (including use of follow-up intervention sessions), and test web-based or mobile technology for follow-up assessment and intervention.

Kevin L. Kraemer, MD, MSc

Reference:

Yuma-Guerrero PJ, Lawson KA, Velasquez MM, et al. Screening, brief intervention, and referral for alcohol use in adolescents: a systematic review. Pediatrics. 2012;130(1):115–122.