Er Advice Helps Crash Victims Ease Off Alcohol

NEW YORK (Reuters Health) - People taken to the emergency room after a car accident involving alcohol use are less likely to suffer additional alcohol-related injuries during the following year if they receive a brief counseling session in the ER, according to new study findings.

The findings suggest that car accidents can make people particularly open to advice about cutting back on alcohol, the authors note.

"Car crashes can be significant events for people," study author Dr. Michael J. Mello told Reuters Health. For instance, people may have to deal with legal issues, car expenses, and guilt from harming other people, the authors write in the Annals of Emergency Medicine.

The "many negative things associated with a car crash can motivate people to look at the role alcohol has in their lives," Mello added.

According to the National Highway Traffic Safety Administration, approximately 40 percent of fatal car crashes involved alcohol in 2002, and nearly one-quarter of people visiting an emergency department after being a driver or passenger during a car accident say that alcohol was involved in the incident.

Previous research has shown that people can respond to brief counseling sessions about the negative effect alcohol has on their lives. To investigate whether counseling in the ER works, Mello and his team assigned 539 ED patients to receive either standard care, a brief motivational intervention, or a brief intervention followed by a second, 40-minute session with a counselor 7 to 10 days later.

The motivational intervention in the ER took place while the patient's blood alcohol level was being allowed to drop. Trained counselors talked to the patient about alcohol use in an "empathetic and respectful" fashion "considered opposite of confrontational approaches."

One year later, participants reported if they had received any additional injuries, and if they had been drinking within 2 hours of the injury.

People who were injured during car accidents who received the intervention plus an additional session had two-thirds fewer additional alcohol-related injuries one year later, relative to people given standard care, the researchers report.

The group that received an additional intervention 7-10 days after their ED visit "did best of all," Mello noted. That additional, "booster" intervention session likely helps because it may take days for people to realize the full impact of their car accident.

"Also, in the ED people are frequently in pain, tired, and frightened and may not hear all that is discussed," he added. "A booster session allows them to review what was discussed and reinforce any plans for change."

SOURCE: Annals of Emergency Medicine, June 2005.