Alcohol Consumption for People Admitted in French Emergency Departments: A Protocol for a Multi-Center Cluster Trial

Introduction

According to a new report published by the World Health Organization (WHO) in May 2014 in Geneva, around the world, people aged 15 or older consume, on average, 6.2 liters of pure alcohol per year. But it is in Europe that alcohol consumption per person is the most prevalent. In 2012, harmful use of alcohol was responsible for 3.3 million deaths worldwide. Drinking alcohol can not only lead to alcohol dependence, but it also increases the risk of developing more than 200 diseases, including liver cirrhosis and some cancer.

In France, recent data from a national epidemiological study show that in the general population in 2014, 86% of persons aged 15–75 said they had drunk alcohol in the last 12 months, an estimated average weekly consumption of 5.5 drinks. Almost half of 15–75-year-olds had consumed alcohol at least once a week, and one in 10 drank it daily. These consumption levels were relatively stable in 2010, except for the daily alcohol consumption, which decreased from 11% to 10%, in line with a trend that has been observed over several decades. Regarding clinical populations, i.e. those hospitalized in medical services or surgery, prevalence of misuse was higher. Reynaud et al. found, in a study of about 10,000 patients hospitalized in medicine, surgery, obstetrics and gynecology and psychiatry departments, on a given day in Auvergne, the prevalence of patients with excessive alcohol consumption and/or possibly alcohol dependence was approximately 20% using the CAGE screening questionnaire. Half of these patients has been classified as having alcohol dependence. Men has been more frequently classified as experiencing alcohol-related issues (34%) than women (8%).

The Emergency Departments (ED) will constitutes a privileged center of care for the identification, early intervention and orientation of patients suffering from alcohol-related issues, especially when the emergency admission is related to somatic or surgical problem. Regarding (ED) in France and despite little available data, 16.5% to 37.5% of all injuries seen by emergency room staff have been reported to be linked to drinking . An older work in United States has observed that 40% of patients entering the ED had consumed alcohol within the six hours before admission. Among these patients, over half have presented pathological consumption of alcohol (risk use, abuse or dependence as defined by the DSM IV–TR).