AMA hits laws impeding screening of drunk patients

These statutes prevent interventions that could help addicted patients, delegates say.

By Tanya Albert, AMNews staff. Jan. 5, 2004.

Honolulu -- Physicians want better screening for alcohol and drugs in patients coming into emergency departments. They're asking states to help them by repealing laws that were passed long before addiction treatment was widely available and trauma centers were commonplace.

These state statutes are based on a model law, the Uniform Accident and Sickness Policy Provision, which includes language permitting insurance companies to refuse to pay for treatment for intoxicated patients' injuries. Since the model law was first proposed more than 50 years ago, 37 states and Washington, D.C., have adopted it.

As a result, screening just isn't done, and valuable chances to help addicted patients are lost.

Physicians at the AMA Interim Meeting last month voted to support state medical and specialty societies and public health associations in efforts to get the laws off the books.

"ERs are less likely to screen for alcohol and drugs because visits won't be covered by [patients'] insurance," said Michael E. Migliori, MD, an ophthalmologist from Providence, R.I., and an AMA delegate. "Repealing the laws will hopefully reduce the recidivism and allow injuries to be covered."

More than 40% of patients treated in EDs are believed to be under the influence of alcohol or other intoxicants, according to information presented at the meeting. But studies estimate that less than 15% of injured hospital patients are screened for alcohol and referred for counseling.