{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T01:28:17Z","timestamp":1778808497549,"version":"3.51.4"},"reference-count":47,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T00:00:00Z","timestamp":1773014400000},"content-version":"vor","delay-in-days":8,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,1]],"date-time":"2026-03-01T00:00:00Z","timestamp":1772323200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["1R25DA058490"],"award-info":[{"award-number":["1R25DA058490"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100019957","name":"National Foundation of Emergency Medicine","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100019957","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Alcohol misuse among midlife and older adults is increasing, and age\u2010related physiological vulnerability heightens the risk for adverse outcomes. Emergency departments (EDs) are key health system touchpoints for identifying alcohol misuse, yet the delivery of evidence\u2010based interventions following screening in this population remains poorly described.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of ED encounters from January 1, 2019\u2013December 31, 2023, across 11 hospital\u2010based EDs in a large integrated health system. We included patients aged \u2265\u200955\u2009years old who screened positive for alcohol misuse using the Alcohol Use Disorders Identification Test\u2013Consumption (AUDIT\u2010C; \u2265\u20094 for men, \u2265\u20093 for women). Primary outcomes were delivery of evidence\u2010based interventions, including brief intervention and referral to treatment and provision of medication for alcohol use disorder (MAUD). Secondary measures included demographics, co\u2010occurring substance use, clinical presentation, and health care utilization. Age\u2010adjusted logistic regression evaluated associations between AUDIT\u2010C score and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 698,308 ED encounters among adults aged \u2265\u200955\u2009years old, 39,912 (5.7%) screened positive for alcohol misuse. Men accounted for 58% of encounters, with gender differences narrowing with age. Co\u2010use of substances was common: 21% reported illicit drug use, 27% cannabis use, and 23% tobacco use, with higher prevalence in younger age groups. Recent opioid and benzodiazepine prescriptions were documented in 12% and 6% of encounters, respectively. Brief intervention and referral to treatment occurred in 30% of encounters overall and in 46% among those with severe misuse. Despite guideline support for pharmacotherapy, MAUD was prescribed in only 3% of encounters.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Among midlife and older ED patients who screen positive for alcohol misuse, delivery of evidence\u2010based interventions, particularly pharmacotherapy, is uncommon despite substantial healthcare utilization and co\u2010occurring risk factors. These findings highlight a gap between identification and treatment and underscore the ED's potential role in initiating evidence\u2010based interventions for alcohol misuse.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acem.70246","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T03:55:51Z","timestamp":1773114951000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Characteristics of Emergency Department Visits Among Midlife and Older Adults Screening Positive for Alcohol Misuse"],"prefix":"10.1111","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1553-3363","authenticated-orcid":false,"given":"Jacob A.","family":"Lebin","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine University of Colorado School of Medicine  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Colin","family":"Hensen","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Informatics, Colorado School of Public Health University of Colorado  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhixin","family":"Lun","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Informatics, Colorado School of Public Health University of Colorado  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1817-0705","authenticated-orcid":false,"given":"Elizabeth M.","family":"Goldberg","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Colorado School of Medicine  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hillary D.","family":"Lum","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, Department of Medicine University of Colorado School of Medicine  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jason A.","family":"Hoppe","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine University of Colorado School of Medicine  Aurora Colorado USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,3,9]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.alcohol.2022.05.005"},{"key":"e_1_2_10_3_1","unstructured":"Center for Behavioral Health Statistics S \u201cKey Substance Use and Mental Health Indicators in the United States: Results from the 2020 National Survey on Drug Use and Health \u201d(2021)."},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.maturitas.2013.02.009"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.35946\/arcr.v38.1.14"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2023.04.013"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/add.15013"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/15563650.2024.2400186"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.acepjo.2025.100247"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-060974"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dadr.2022.100049"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/emp2.12196"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.14911"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.annemergmed.2024.01.033"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.158.16.1789"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/10826080701351507"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/acem.12569"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/13607860600637729"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/acer.13449"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/gps.2498"},{"key":"e_1_2_10_21_1","unstructured":"National Institute on Alcohol Abuse and Alcoholism \u201cUnderstanding Alcohol Drinking Patterns \u201d(2025) https:\/\/www.niaaa.nih.gov\/alcohols\u2010effects\u2010health\/alcohol\u2010drinking\u2010patterns."},{"issue":"10","key":"e_1_2_10_22_1","first-page":"1628","article-title":"Strengthening the Reporting of Observational Studies in Epidemiology (STROBE): Explanation and Elaboration","volume":"4","author":"Vandenbrouckel J. 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