{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T13:05:28Z","timestamp":1777381528370,"version":"3.51.4"},"reference-count":24,"publisher":"CSIRO Publishing","issue":"2","license":[{"start":{"date-parts":[[2025,5,29]],"date-time":"2025-05-29T00:00:00Z","timestamp":1748476800000},"content-version":"vor","delay-in-days":2702,"URL":"https:\/\/doi.org\/10.1071\/journalslicense"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,4,4]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>In response to escalating alcohol and other drug (AOD)-related emergency department (ED) presentations, a tertiary Melbourne hospital embedded experienced AOD clinical nurse consultants in the ED on weekends to trial a model for screening, assessment and brief intervention (BI). The aim of the present study was to evaluate the relative contributions of AOD to ED presentations and to pilot a BI model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a customised AOD screening tool and a framework for proactive case finding, screened participants were offered a comprehensive AOD assessment and BI in the ED. Immediate effects of the intervention were evaluated via the engagement of eligible individuals and a self-administered \u2018intention to change\u2019 survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over the 32-month pilot, 1100 patients completed a comprehensive AOD assessment, and 95% of these patients received a BI. The most commonly misused substances were, in order, alcohol, tobacco, amphetamine-type stimulants, gamma-hydroxybutyrate and cannabis. Thirty-two per cent of patients were found to be at risk of dependence from alcohol and 25% were found to be at risk of dependence from other substances. Forty per cent of the people assessed reported no previous AOD support or intervention. On leaving the ED, 78% of participants reported an intention to contact community support services and 65% stated they would change the way they used AOD in the future.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study of a pilot program quantifies the relative contribution of AOD to ED presentations and demonstrates that hospital EDs can implement a feasible, proactive BI model with high participation rates for people presenting with AOD-related health consequences.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>What is known about the topic?<\/jats:title>\n                    <jats:p>Clinician-led BI for high-risk consumption of alcohol has been demonstrated to be effective in primary care and ED settings. However, hospital EDs are increasingly receiving people with high-risk AOD-related harms. The relative contribution of other drugs in relation to ED presentations has not been widely documented. In addition, the optimal model and effects of AOD screening and BI programs in the Australian ED setting are unknown.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>What does this paper add?<\/jats:title>\n                    <jats:p>This paper describes a \u2018real-life\u2019 pilot project embedding AOD-specific staff in a metropolitan Melbourne ED at peak times to screen and provide BI to patients presenting with AOD-related risk and\/or harms. The study quantifies the relative contribution of other drugs in addition to alcohol to ED presentations and reports on this model\u2019s much higher levels of patient engagement in receiving BI than has been reported previously.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>What are the implications for practitioners?<\/jats:title>\n                    <jats:p>This study demonstrates the relative contribution of drugs, in addition to alcohol, to ED presentations at peak weekend times. Although BI has been well proven, the pilot project evaluated herein has demonstrated that by embedding AOD-specific staff in the ED, much higher rates of patient engagement, screening and BI can be achieved.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1071\/ah17148","type":"journal-article","created":{"date-parts":[[2018,1,4]],"date-time":"2018-01-04T00:05:30Z","timestamp":1515024330000},"page":"188-193","source":"Crossref","is-referenced-by-count":5,"title":["A feasible model for early intervention for high-risk substance use in the emergency department setting"],"prefix":"10.1071","volume":"43","author":[{"given":"Rebecca","family":"Howard","sequence":"first","affiliation":[{"name":"AComplex Care Services, St Vincent\u2019s Hospital Melbourne, 41 Victoria Parade, Fitzroy, Vic. 3065, Australia."},{"name":"ECorresponding author. Email: Rebecca.Howard@svha.org.au"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Fry","sequence":"additional","affiliation":[{"name":"AComplex Care Services, St Vincent\u2019s Hospital Melbourne, 41 Victoria Parade, Fitzroy, Vic. 3065, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrew","family":"Chan","sequence":"additional","affiliation":[{"name":"AComplex Care Services, St Vincent\u2019s Hospital Melbourne, 41 Victoria Parade, Fitzroy, Vic. 3065, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Brigid","family":"Ryan","sequence":"additional","affiliation":[{"name":"CSt Vincent\u2019s Mental Health, 46 Nicholson St, Fitzroy, Vic. 3065, Australia. Email: Stephanie.Fry@svha.org.au"},{"name":"DDepartment of Medicine, The University of Melbourne, Parkville, 3010, Victoria, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yvonne","family":"Bonomo","sequence":"additional","affiliation":[{"name":"BDepartment of Addiction Medicine, St Vincent\u2019s Hospital Melbourne, 41 Victoria Parade, Fitzroy, Vic. 3065, Australia."},{"name":"DDepartment of Medicine, The University of Melbourne, Parkville, 3010, Victoria, Australia."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"67","published-online":{"date-parts":[[2018,1,4]]},"reference":[{"key":"2025121500462775500_R1"},{"key":"2025121500462775500_R2","unstructured":"Foundation for Alcohol Research and Education. Risky business: the alcohol industry\u2019s dependence on Australia\u2019s heaviest drinkers. 2016. 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Inquiry into Supply and Use of Methamphetamines, Particularly \u201cIce\u201d, Parliament of Victoria, Law Reform, Drugs and Crime Prevention Committee. Submission to the public hearing in Geelong on Monday 28th of October 2013 by representatives of Barwon Health. 2013. Available at: http:\/\/www.parliament.vic.gov.au\/images\/stories\/LRDCPC\/Submissions\/Submission_42_-_Barwon_Health_-_ED_ and_DAS_response.pdf [verified 5 January 2016]."},{"key":"2025121500462775500_R11","unstructured":"St Vincent\u2019s Health Australia. Submission to Department of the Prime Minister and Cabinet\u2019s National Ice Taskforce on improving the efforts of the federal, state and territory governments to combat the growing use of ice in our community. 2015. 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