Emergency Room Drug Abuse Treatment

Abstract

The Long Island Jewish Hillside Medical Center recently received a National Institute on Drug Abuse grant to better serve addicts/abusers in the emergency room. After six months addicts/abusers appear to be receiving better care.

To understand the treatment of addicts/abusers in the emergency room it is necessary to understand that many emergency rooms are used as outpatient clinics and/or family doctors, and that overall many emergency rooms have seen their number of patient visits double in the past fifteen years.

As a consequence of this rapid rise emergency room staff make judgements concerning patients' social worth and appropriateness for treatment and vary their delivery of service accordingly. Triage category and source of referral are two ways emergency room staff operationally define appropriateness. “Contract referrals” are more likely to be seen as appropriate in the emergency room, holding triage category and social worth constant. Contract referrals may even be seen as appropriate when clearly non-emergency triage categories are involved.

Most addicts/abusers present at emergency rooms have non-emergent problems and are ranked low in terms of social worth. The improving care they received in this project may be related to the legitimacy bestowed upon them as a result of their contract status. As part of a governmentally funded project these patients may have in effect been defined as a new contract group. An important serendipitous outcome of governmentally funded emergency room drug abuse programs may be the change in perceived referral source for addicts/abusers presenting to the emergency room.