Alcohol use disorders in the emergency ward: choice of the best mode of assessment and identification of at-risk situations

BACKGROUND: This study aims to identify the prevalence and at-risk situations of alcohol use disorders among patients examined in the emergency department and to compare the scales commonly used to identify alcohol use disorders. METHODS: We used the CAGE and AUDIT questionnaires and a structured interview, the MINI. FINDINGS: Of the presenting patients, 9.5% met the DSM-IV criteria for alcohol use disorders. The CAGE questionnaire was less sensitive (75%) and more specific (92%) than the AUDIT (87 and 80%, respectively). The typical alcohol-dependent patient is a young man who is unemployed and brought to the emergency department by the police. During the past 24 h, he has consumed alcohol, nicotine, cocaine, sedatives or cannabis. CONCLUSION: Of the patients, 9.5% examined in the emergency department present with alcohol abuse or dependence without asking spontaneously for treatment for their addiction. These results support the importance of systematically identifying alcohol use disorders with a simple and rapid questionnaire such as the CAGE questionnaire.