Estimated rates of detection, inpatient intervention, and treatment referral of alcohol use disorders in hospital admissions were low. Current-drinking hospital admissions should be screened for alcohol problems as part of the admission routine, with further professional evaluation, intervention, and treatment referral as indicated.

The prevalence of alcohol abuse or dependence in current-drinking admissions was substantial, suggesting that hospitalization offers a unique opportunity to identify alcohol use disorders. Further research is needed to determine factors that may be associated with significant pairwise results, especially for race or ethnicity. We recommend alcohol screening of all hospitalized drinkers, followed, as appropriate, by diagnostic evaluation and referral or intervention.

This study estimated the prevalence and explored the management of illicit drug use, illicit drug use associated with alcohol use disorder (AUD), and AUD without reported illicit drug use in a national sample of 2040 admissions to general hospitals in the United States. Surveyed in 1994, admissions were diagnosed with past 12-month DSM-IV AUD according to the Alcohol Use Disorders and Associated Disabilities Interview Schedule. Information about drug use was also included in the interview. Entries in hospital records were used to operationalize management. Prevalence of chronic drug use in hospital admissions was 5%, 14% in 18-44-year-old admissions, and 31% in admissions with an AUD. In admissions with an AUD, 45% reported no drug use. Detection rates were 82% for admissions with comorbid AUD and chronic drug use (where detection of either problem was assessed); detection rates hovered around 50% in admissions with one or the other condition. Low rates of treatment and referral (33% and 42%, respectively) were observed in the comorbid group; rates were 13-17% in admissions with AUD alone or illicit drug use alone. Findings indicate the need for increased attention to drug use and to AUD with and without other drug use among general hospital admissions.

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