Treatment and outcomes of patients presenting to an adult emergency department involuntarily with substance misuse.

Alcohol and other drug (AOD) use is common in our society. The use of these substances flow throughout all areas of healthcare, and is especially prevalent in patients presenting to the emergency department with signs of mental illness. At the extreme end of these presentations patients present involuntarily with either police or ambulance officers. The aim of this study was to identify and describe the population presenting to the ED involuntarily with and without substance misuse as a precipitating factor. Quantitative descriptive analysis was used to describe this population between April and June 2015. In patients presenting to one large inner city emergency department involuntarily, 30% had alcohol or other drug misuse as a precipitating factor. Patients who involuntarily presented with alcohol and other misuse stay longer in the emergency department then others that do not have alcohol or other drug misuse. These patients represent frequently, with over 50% representing at 90 days however this was not associated with alcohol or other drug misuse. Almost all patients who present involuntarily are discharged home post review by a mental health team. Significant improvements in care can be made in this population if the opportunistic treatment of both mental illness and AOD misuse is completed in the emergency department.