Alcohol-related ER Visits Increase as Drinking Decreases?

Megan Patrick and Yvonne Terry-McElrath address the disconnect between increasing drinking-related ER visits and decreasing teen alcohol use. They respond to a recent paper by White and colleagues showing that ER visits for acute and chronic alcohol problems have increased dramatically between 2006 and 2014.


White et al. break down these increases by age group: ER visits have increased significantly for all adult age groups but adolescent ER visits have increased only for chronic alcohol problems and have decreased for overall and acute alcohol problems.


Patrick and Terry-McElrath explore two possible, partial explanations based on their work in age-specific patterns of drinking. First, they look at increases in the intensity of alcohol use. The prevalence of high-intensity drinking (10+ and 15+ drinks in a row) increases with age from adolescence into young adulthood. High-intensity drinking among teens has decreased in recent years, though 15+ drinking has decreased more slowly than 10+ drinking. In young adult age groups, high–intensity drinking has decreased among 18-24 year olds, remained more or less the same for ages 25-28, and increased among 29-30 year olds. National data show higher increases in intense drinking among middle-aged adults (compared to other adults), who have also shown higher increases in drinking-related ER visits in White’s study.


Second, Patrick and Terry-McElrath look at combined use of alcohol and other drugs, use by which the effects of alcohol and other drugs overlap. According to White et al., 1 in 6 alcohol-related ER visits involves another drug and involvement of another drug increases the likelihood of hospital admission. Patrick and Terry-McElrath have shown that simultaneous use of alcohol and marijuana appears to be on the increase among young adults. Teens who use alcohol and marijuana at the same time are more likely to engage in high-intensity drinking. The same is true for teens who co-use alcohol and nonmedical prescription drugs (opioids, sedatives, stimulants, or tranquilizers not used as prescribed). Nonmedical prescription drug use has increased among young adults and those 50 or older in the last decade.


To read more about age-specific overlap between ER and substance use findings, see Patrick and Terry-McElrath’s commentary in Alcoholism: Clinical and Experimental Research, based on the January 2018 paper by White et al. on trends in alcohol-related ER visits.

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