Technical Report Documentation Page

1. Report No.
 DOT HS 809 412
2. Government Accession No.
3. Recipient's Catalog No.
4. Title and Subtitle

Identification and Referral of Impaired Drivers Through Emergency Department Protocols

5. Report Date
February 2002
6. Performing Organization Code
7. Author(s)

Runge, J.; Garrison, H,; Hall, W.;Waller, A.; and Shen, G.

8. Performing Organization Report No.


9. Performing Organization Name and Address

Carolinas Health Care System

10. Work Unit No. (TRAIS)
11. Contract or Grant No.
12. Sponsoring Agency Name and Address

National Highway Traffic Safety Administration
Office of Research and Traffic Records
Research and Evaluation Division
400 7th Street, S.W.
Washington, DC 20590

13. Type of Report and Period Covered

Final Report

14. Sponsoring Agency Code
15. Supplementary Notes

Jon Walker and Amy Berning were the Contracting Officer's Technical Representatives on this project

16. Abstract

Objectives: Of patients treated in the emergency department (ED) following motor vehicle crash (MVC), 15-20% are at high risk for alcohol abuse or alcohol dependency (AA/AD), and are likely to drive after drinking. In order to intervene with patients at high risk in the ED, a reliable and quick screening procedure and a method of intervention must be available. We investigated whether an ED intervention protocol to identify and refer patients with AA/AD would result in more patients receiving treatment and evaluation for substance abuse. 
Methods: The prospective, randomized, controlled study was performed at two EDs with a combined census of 120,000 patients of driving age. Consecutive patients over 17 years of age treated in the ED for MVC injury from 10 AM to 10 PM over a 1 year period were studied. Excluded were patients admitted greater than 24 hours, unconscious or too impaired to cooperate with the questions, and those who could not communicate in English. Patients were screened for AA/AD using a previously validated screening tool (TWEAK). Those at high risk of AA/AD were randomized to a group receiving the intervention protocol or to a control group (no intervention). The intervention protocol was a standard scripted protocol used by all interviewers, ending with a recommendation for definitive evaluation and treatment. Patients were followed up by phone at 3 and 6 months. Groups were compared to determine the likelihood of actually receiving treatment for AA/AD. 
Results: Of those receiving the intervention, 25 out of 130 (19.2%) received a formal evaluation, compared to 7 out of 157 (4.5%) in the control group [OR = 5.1, 95%, CI = 2.128 12.235]. Of those persons who agreed to an evaluation, 21 out of 43 (48.8%) showed up for the evaluation. 
Conclusion: An ED protocol for screening and intervention for patients at high risk of AA/AD increases the likelihood of receiving definitive treatment for AA/AD.

17. Key Words
  • Drinking and Driving 
  • DWI
  • DUI
  • Alcohol Screening 
  • Brief Interventions
18. Distribution Statement

This report is available from the National Technical Information Service in Springfield, Virginia 22161, (703) 605-6000; and free of charge at the National Highway Traffic Safety Administration's web site at

19. Security Classif. (of this report) 20. Security Classif. (of this page)


21. No. of Pages


22. Price
Form DOT F 1700.7 (8-72) Reproduction of completed page authorized

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