Parkman Thomas, Neale Joanne, Day Ed, Drummond Colin
a National Addiction Centre , Institute of Psychiatry, Psychology and Neuroscience (IOPPN) , London , UK.
b Centre for Social Research in Health , University of New South Wales , Sydney , Australia.
Subst Use Misuse. 2017 Sep 19;52(11):1460-1468. doi: 10.1080/10826084.2017.1285314. Epub 2017 May 3.
People who frequently attend emergency departments (EDs) for alcohol-related reasons, cost health systems greatly. Although specialist addiction services may be more appropriate for their needs, drinkers often experience barriers accessing specialist alcohol-related support.
This study explores how people who frequently attend EDs for alcohol-related reasons use, view, and experience specialist addiction services.
We conducted semi-structured interviews with 30 individuals recruited from six EDs across London, United Kingdom. Data relating to participants' socio-demographic characteristics and service use were systematically coded using qualitative software, and analyzed following the Framework.
ED usage over the last 12 months was high, whereas current use of specialist addiction services was low. We found little evidence that structural barriers were preventing participants from attending specialist services; rather, participants seemed not to require help with their alcohol use. When asked what support they desired for their drinking, only 11/30 participants identified alcohol-specific treatment. More commonly, they wanted help relating to mental health problems; social contact; paid or voluntary work; housing-related issues; or gym access. Women were more likely to be receiving, and to have support from a specialist addiction service. Conclusions/Importance: People who frequently attended EDs for alcohol-related reasons expressed low levels of interest in, and motivation for, alcohol-specific treatment but desired broader psychosocial support. Case management and assertive outreach appear to be valuable models of service delivery for this population (particularly for men). However, further qualitative and quantitative research is now needed to verify these findings in different countries, regions, and health care systems.
因酒精相关原因频繁前往急诊科（ED）的人群给卫生系统带来了巨大成本。尽管专科成瘾服务可能更符合他们的需求，但饮酒者在获得与酒精相关的专科支持方面常常遇到障碍。
本研究探讨因酒精相关原因频繁前往急诊科的人群如何使用、看待和体验专科成瘾服务。
我们对从英国伦敦六个急诊科招募的30名个体进行了半结构化访谈。使用定性软件对与参与者社会人口学特征和服务使用相关的数据进行系统编码，并按照框架进行分析。
过去12个月急诊科使用率很高，而目前专科成瘾服务的使用率很低。我们几乎没有发现结构性障碍阻止参与者前往专科服务机构的证据；相反，参与者似乎不需要在饮酒方面获得帮助。当被问及他们希望在饮酒方面得到何种支持时，只有11/30的参与者提到了针对酒精的治疗。更常见的是，他们希望在心理健康问题、社交联系、有偿或志愿工作、住房相关问题或健身房使用方面获得帮助。女性更有可能接受专科成瘾服务并得到其支持。结论/重要性：因酒精相关原因频繁前往急诊科的人群对针对酒精的治疗兴趣和动机较低，但希望获得更广泛的心理社会支持。病例管理和积极外展似乎是为这一人群（特别是男性）提供服务的有价值模式。然而，现在需要进一步的定性和定量研究，以在不同国家、地区和医疗保健系统中验证这些发现。
