Establishment and evaluation of a statewide drug and alcohol specialist advisory service

The New South Wales Drug and Alcohol Specialist Advisory Service aims to provide prompt, relevant and reliable advice on the clinical management of drug- and alcohol-related problems to health professionals throughout New South Wales. We gauged the performance of the Service against present indicators by interviewing 120 callers who had contacted the Service during its first two years. Accessibility and the quality of information provided were rated highly. Of the 120 respondents, 105 (90 per cent) rated the speed of response to their calls as very good or excellent, and 109 (91 per cent) considered the advice given to be very relevant to their needs. Nearly all (97 per cent) indicated their intention to reuse the Service, and 78 (65 per cent) nominated it as their preferred source of clinical advice on drug and alcohol problems. The Service has established itself as an accessible and reliable source of advice on the management of drug and alcohol problems, especially for rural health professionals. This model of a telephone-based consultancy could have application in other medical specialities.

Problem drinking in emergency department patients: the scope for early intervention

OBJECTIVE

To determine the prevalence of previously undiagnosed problem drinking and thereby to assess the suitability of the emergency department for early intervention.

DESIGN

Three hundred and fifty ambulatory care patients were assessed by means of a structured interview schedule, physical examination and blood tests. Alcohol intake and presence of alcohol-related problems were recorded, along with history of past advice on drinking and self-perception of an alcohol problem.

SETTING

The ambulatory care section of the emergency department of Royal Prince Alfred Hospital, Sydney.

PATIENTS

Three hundred and fifty subjects, aged between 18 and 55 years, were sequentially selected over an 18-month period.

RESULTS

Forty-one per cent of subjects (95% confidence interval, 36%-46%), 50% of men and 26% of women, were classified as problem drinkers on the basis of hazardous or harmful levels of alcohol consumption, frequent drinking to intoxication, evidence of dependence, or experience of alcohol-related problems. Of these, 63% had not previously received advice on drinking from a health professional and only 28% perceived they had a problem. Of particular note was that 24% of men and 4% of women were drinking 12 or more drinks (120 g of alcohol or more) in a single session on a weekly or more frequent basis.

CONCLUSIONS

Many of the problem drinkers attending the emergency department have not previously received advice about their drinking from a health professional. The emergency department therefore offers considerable potential as a site for early detection and intervention in patients with hazardous and harmful alcohol use and related disorders.

Prevalence of alcoholism in a Sydney Teaching Hospital: some aspects

This paper presents some preliminary findings from an epidemiological study of inpatients in Royal Prince Alfred Hospital in 1977. The sample included 457 patients. Of these, 15% were found to have alcohol-related reasons for admission to hospital, and 33% had concomitant alcohol problems. The drinking habits of 30% of males and 9% of females placed them at risk. Some commonly used laboratory tests are evaluated.