Georgia Researcher Receives Program Committee Award

J. Aaron Johnson, Ph.D.

J. Aaron Johnson, Ph.D.

Researcher J. Aaron Johnson, Ph.D., landed the 2012 Medical-Scientific Program Committee Award for his study comparing the Drinkers Pyramid to rates of unhealthy alcohol use, including abuse and dependence, in emergency departments and urgent care settings.

Dr. Johnson, Faculty Research Scientist for the Department of Family Medicine, Medical Center of Central Georgia and Mercer University School of Medicine, Macon, Ga., earned this award along with co-authors from the same institution, Alexandra Woycheck and J. Paul Seale, M.D. ASAM will present this prestigious award at the 2012 Awards Luncheon from noon to 2:15 p.m. Saturday in Grand Ballroom East, Ballroom AB. Dr. Johnson will discuss Paper 5 “Comparing the Drinkers Pyramid to Prevalence of At-risk Use and Alcohol Use Disorders in Emergency Depart­ment and Urgent Care Settings” from 11 a.m. to 1 p.m., today during Paper Session I in Grand Salon East, Salon A.

This research focuses on detecting at-risk drinking in patients admitted to various health care settings, Dr. Johnson notes.

“Nationally, more than 4.6 million emergency department visits each year are drug and alcohol related,” he says. “If we can begin to reduce just a small portion of these through our SBIRT work, then I think we have been successful. When we conduct screenings in emergency departments and urgent care settings in my area, for example, we find that more than one in five patients screen positive for at-risk alcohol and/or drug use.”

In his research, Dr. Johnson explains the common and accepted use of the Drinkers Pyramid in demonstrating the extent of alcohol-use risk levels within the U.S. population. While the largest segment is represented in the no-risk (nondrinkers) or low-risk categories, the Drinkers Pyramid indicates that 28 percent of the U.S. population is either at-risk for alcohol-related problems or is alcohol dependent.

The Drinkers Pyramid represents the U.S. population as a whole, Dr. Johnson says. Yet, little research exists comparing these statistics to the degree of alcohol use problems treated in various health care settings. For the purpose of making this comparison, his research involved collecting data from two Georgia emergency departments and three urgent care centers. Nearly 12,000 patients were screened in a large, urban emergency department, assessed using the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) and categorized, based on their scores, into areas of risk similar to those in the Drinkers Pyramid.

Of those patients, Dr. Johnson says, 32 percent screened at-risk or higher. In smaller Georgia markets, the team screened 21,559 emergency department patients and 1,244 urgent care patients. Twenty-one percent of ED patients were at-risk or higher, while 26 percent of urgent care patients were at-risk or higher, he notes.

The comparison yielded similar percentages to the Drinkers Pyramid. However, Dr. Johnson says the findings suggest some variation across settings, with large urban health care centers treating a higher number of at-risk alcohol users. All health care settings showed slightly lower percentages of possible dependence than the Drinkers Pyramid, he reports.

“This was a simple analysis, but the takeaway is important. We’re seeing the increasing value of SBIRT to effectively identify patients who may need minimal intervention to reduce alcohol use,” Dr. Johnson says. “There’s good evidence that drinking within healthy limits can significantly reduce risk of injury and many other alcohol-related health issues. Long term, it can result in significant health care cost savings through reductions in emergency department visits, trauma episodes, costly inpatient stays, etc. Many of the individuals we serve today won’t progress into long-term harmful alcohol use tomorrow.”