What I've Seen So Far...

Since my last post I have put in a few hours conducting substance abuse history surveys for every patient that is seen in the ED at UAB. As a caveat, I also work as a Student Nurse Tech at another ED that does not have quite as much patient volume and primarily treats patients in a lower SES. Through this work opportunity I have seen a few cases of drug overdoses and catered to patients that just needed a place to sleep off the nights consumption of liquor. However, I am often times left out of any collection of prior history of substance abuse with these patients, if any is collected at all. So I like to think of my opportunity with UAB's Emergency Department as a way of refining a skill that will become valuable later on in my nursing career. It can be difficult at times to get patients comfortable enough in the hectic environment of the ER to disclose information regarding drugs and alcohol. This issue is often times compounded with concerned or worried family members that refuse to let the patient answer questions for themselves. I've learned that therapeutic communication such as asking what brings the patient to the ER and telling them about myself develops a sense of trust.
After the first few days of data collecting I've noticed in my small sample size that alcohol tends to be the most prevalent substance of abuse. Several patients (most above the age of 40) have had extensive backgrounds including many different treatment programs, broken marriages, and lost relationships with their children. Here are some statistics from the National Survey on Drug Use and Health 2010:

• 4.7 million Americans age 12 and above initiated their first use of ETOH.
• 82.4 percent of those 4.7 million Americans were under the age of 21.
• The average age of first use of alcohol in 2010 was 17.2 years.
• 17 million Americans were identified as needing specialty treatment for alcohol abuse....and did not receive any such treatment.
• In 2010 1.1 million youths were identified as needing specialty treatment for alcohol abuse and did not receive any such treatment.

The Beginning

My name is Ben Smith, and I am currently a 3rd semester honors in nursing student at UAB. I'm originally from Agawam, Massachusetts and a veteran of the U.S. Navy. I moved to Birmingham in 2008 after I was discharged from the Navy and was employed part-time at an urgent care center in the suburbs of the city. Here is where I became increasingly aware of the issue of drug seeking behavior, and other health issues related to substance abuse resulting in the over-crowding of health care facilities all over Birmingham.
When I first started my service-learning project the initial target population was the veterans using the VA health care system that had been given a diagnosis pertaining to opioid dependence. My goal was to develop an effective referral system for patients admitted to the hospital to make the transition from hospitalization to to substance abuse treatment an easier process for the veterans.  Since then, my community agency has shifted to University Hospital's emergency department where a study has been in the works since May of 2011. The overall aim of this study is to minimize emergency room visits and hospital admissions by identifying potential substance abuse behavior and pairing the patient with the appropriate treatment center. A little motivation for these patients may prove to go a long way in their path to recovery...