Yale School of Medicine, Department of Emergency Medicine, New Haven, Connecticut.
Yale Program in Addiction Medicine, New Haven, Connecticut.
West J Emerg Med. 2022 Jul 11;23(4):443-450. doi: 10.5811/westjem.2022.5.55475.
The clinical model of screening, providing a brief psychosocial and/or pharmacological intervention, and directly referring patients to treatment (SBIRT) is a compelling model to address drug use among assault-injured individuals in the busy emergency department (ED) setting. Our objective in this study was to examine the current literature and determine ED-based strategies that have been reported that screen, directly refer to drug mis-use/addiction specialized treatment services, or initiate addiction treatment among individuals injured by non-partner assault in the United States.
We conducted a systematic review of ED-based studies using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocol. OVID, MEDLINE, OVID Embase, OVID AMED, Web of Science-Core Collection, Cochrane CENTRAL, and CINAHL were systematically searched using keywords and Medical Subject Heading terms. Studies were excluded if they only involved intimate partner assault-injury, tobacco, or alcohol use. We categorized ED-based strategies as screening, direct referral, or treatment initiation.
Of the 2,076 non-duplicated studies identified, we included 26 full-text articles in the final analysis. Fourteen studies were cross-sectional, 11 were cohort, and one was case-control in design. The most common drug use screening instrument used was the National Institute on Drug Abuse Quick Screen Question. Cannabis was the most common drug detected upon screening.
Drug use, while highly prevalent, is a modifiable risk factor for non-partner assault-injury. The paucity of scientific studies is evidence for the need to intentionally address this area that remains a major challenge for the public's health. Future research is needed to evaluate ED-based interventions for drug use in this population.
筛选、提供简短的心理社会和/或药物干预，并直接将患者转介至治疗（SBIRT）的临床模式是一种引人注目的模型，可以解决繁忙的急诊部门（ED）中因攻击受伤的个体的药物使用问题。我们本研究的目的是检查当前的文献，并确定在美国，ED 中已报告的那些筛选、直接转介至药物滥用/成瘾专门治疗服务或开始对非伴侣攻击受伤个体进行成瘾治疗的策略。
我们使用系统评价和荟萃分析报告的首选项目协议对 ED 基础研究进行了系统评价。使用关键词和医学主题词在 OVID、MEDLINE、OVID Embase、OVID AMED、Web of Science-Core Collection、Cochrane CENTRAL 和 CINAHL 中进行系统搜索。如果研究仅涉及亲密伴侣攻击伤害、烟草或酒精使用，则将其排除在外。我们将 ED 基础策略分为筛查、直接转介或治疗启动。
在 2076 篇非重复研究中，我们最终分析中包括了 26 篇全文文章。其中 14 项研究为横断面研究，11 项为队列研究，1 项为病例对照研究。最常用的药物使用筛查工具是国家药物滥用研究所快速筛查问题。在筛查中最常检测到的药物是大麻。
药物使用虽然普遍存在，但也是非伴侣攻击伤害的可改变风险因素。科学研究的缺乏证明需要有针对性地解决这一仍然是公共卫生主要挑战的领域。需要进一步研究评估该人群中 ED 基础干预药物使用的效果。
