Tackling alcohol misuse at the front line

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Abstract
Emergency departments Funding by primary care trusts for alcohol services could be well used in hospital emergency departments, where nearly a third of overall attendances are alcohol related and more than two thirds may be so after mid-night. Over the past 12 years,3 4 a pragmatic randomised controlled trial carried out by the emergency department team at St Mary's Hospital London has shown that routine clinical staff can be trained to detect potential alcohol problems by using the evolving one minute Paddington alcohol test in patients with certain defined conditions,5 and that they can then offer brief advice. In addition, an alcohol health worker based in the hospital and funded by the local primary care trust is available for brief intervention and, where necessary, referral to community care or for specialist opinion. The important part played by the alcohol health worker in educating staff and in supporting them in a stressful environment is an essential part of the programme, and this approach is cost effective.6

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