TALKS WITH ALCOHOLICS CUT INJURIES

BOSTON (AP) _ A brief talk with hospitalized injury patients about their
drinking problems dramatically reduced their risk of getting injured again,
a study has found.

The 30-minute conversation with a psychologist cut the risk nearly in half,
prompting one trauma surgeon to call the study "ground-breaking" evidence
that such brief interventions can make a difference.

The work was done in a trauma center, which provides specialized care for
life-threatening injuries like those from crashes or violence. But a
similar program might also work in hospital emergency rooms, said Dr. Larry
Gentilello.

Gentilello, a trauma surgeon at the Harborview Medical Center of the
University of Washington School of Medicine in Seattle, presented the
results Sunday at the annual meeting of the American Psychological Association.

"It's ground-breaking work," declared another trauma surgeon, Dr. Carl A.
Soderstrom of the University of Maryland's trauma center in Baltimore. It's
the first evidence that such a brief intervention can help with alcohol
problems in that setting, he said.

"It will get the attention of the rule-makers in emergency departments and
trauma centers," said Soderstrom, who's planning another study of the approach.

Currently, trauma centers generally don't address the problem of alcohol
abuse in their patients, even though it's a potent factor in causing
injuries, Gentilello said.

While the brief intervention didn't help severely dependent alcoholics, it
did show an effect in people with mild to moderate alcohol problems, he
said. Such people are involved in most alcohol-related crashes, he said.

His study screened 2,574 trauma center patients for drinking problems by
measuring blood alcohol levels, testing for evidence of impaired liver
function and administering a 15-item questionnaire. The questionnaire asked
about such things as whether the person had tried to cut down on drinking
or drank in the morning, or whether his or her family was upset about the
drinking.

Forty-six percent of the patients showed evidence of a drinking problem,
and 762 of them were randomly assigned to get either the brief intervention
or just normal care. Some assigned to the intervention were discharged
before it could be done, so eventually 304 patients got it and 396 were
assigned to the no-intervention group.

For the intervention, a psychologist first described the results of the
screening tests and asked the patient's reaction to the fact that his or
her blood alcohol level, for example, would boost the risk of a crash some
300-fold.

The psychologist then made clear it was the patient's responsibility to do
something about the drinking problem, if the patient chose to, and provided
encouragement that the problem could be overcome.

After listing options for treatment, but without forcing the patient to
choose, the psychologist offered empathy and further encouragement that the
problem could be dealt with.

A month later, the patient got a letter summarizing the conversation,
offering further encouragement and a phone number to clear up any questions.

Researchers used hospital records to show that people in the intervention
group were far less likely to show up again for treatment of injuries than
the patients who hadn't gotten the intervention.

There was a 48 percent difference for either inpatient or outpatient
treatment at Harborview within one year. For inpatient treatment anywhere
in the state, the difference was 47 percent for periods of up to three years.

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