Problems and costs associated with alcohol and drug abuse in emergency medicine

Abstract

Preclinical care refers to patients with life-threatening conditions. It remains unclear how alcohol and drug abuse contribute to the frequency and severity of emergency cases. This study evaluated the influence of these psychotropic substances on preclinical emergencies and the social security costs arising from this. The records of 400 emergency patients were analyzed prospectively regarding type and severity of emergency, intake of psychotropic substances before the emergency, and their influence on patients' outcome. Psychotropics were detected in 19% of patients; 84% of these patients (vs. 55% overall) were scored below 4 (not life threatening) on the National Advisory Committee for Aeronautics scale and therefore did not require a physician on-site. Alcohol or drug intake frequently causes emergencies with physicians on-site; retrospectively 84% of these interventions were thus found to be unnecessary, caused by difficulties in recognizing the severity of the disorder, especially in mental or respiratory disorders. Extrapolated to Germany overall this means 675,000 drug-related emergencies yearly, costing euro 310,000,000.

Troubles psychotiques et consommation de substances psychoactives : impacts d’une intervention concertée

“…Alors qu'au premier regard un programme intégré d'intervention comme Rond Point qui est très spécialisé semble présenter des coûts importants, lorsqu'on considère les coûts, il faut se rappeler que les personnes ayant un TUS présentent de hauts taux d'hospitalisation et d'utilisation des services ambulatoires (Huber et al, 2006 ;Kline-Simon et al, 2014) et qu'en combinant un trouble de santé mentale sévère et persistant, ces personnes requièrent des niveaux de soins plus élevés en raison de leurs besoins complexes (Banerjee et al, 2002). La diminution importante de l'utilisation des urgences et des hospitalisations obtenue ici indique clairement que la participation au programme RP contribue à diminuer les coûts des soins de santé offerts à ces personnes de même que les coûts pour le système de santé.…”