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Dr. Brian Suffoletto is an emergency physician and Assistant Professor of Emergency Medicine at the University of Pittsburgh Medical Center. As the 2010 recipient of an Emergency Medicine Foundation Society for Academic Emergency Medicine Medical Student Research Grant, Dr. Suffoletto was able to utilize social media technology (texting) as an intervention tool to reach young adults who binge drink.

I’ve been an Emergency physician for many years. In that time, I’ve seen concussions, broken bones, car crashes, and injuries from young adults consuming too much alcohol. What is most bothersome is that all of these mishaps can be prevented. In addition to being a doctor, I’m a father. As a parent, I want to do everything I can to help young people stay safe and make smart decisions. It is why I’m so proud to be working on a text message (SMS) based intervention research project to fight binge drinking here in Pittsburgh.

Excessive alcohol consumption, primarily in the form of binge drinking (≥4 drinks for women; ≥5 drinks for men, per occasion), is responsible for an average of 80,000 deaths in the U.S. each year. Binge drinking also is associated with social problems, such as motor vehicle crashes and interpersonal violence. In the 2010 National Survey on Drug Use and Health, young adults (18-25 years of age) had the highest prevalence of hazardous alcohol use among all age groups, including 41% who drank ≥5 drinks on a single occasion in the prior month. Despite the high rates of binge drinking and associated harms among young adults, two thirds do not believe that having 5 or more drinks per occasion is risky and most do not seek help for hazardous alcohol use. For these reasons, hazardous drinking among young adults often goes unrecognized, and overall drinking rates among young adults have remained relatively unchanged since 1990.

Each day in the US, there are over 50,000 emergency department (ED) visits by young adults 18-24 years of age. A quarter of young adults use the ED for primary care and up to a half may have hazardous alcohol use patterns (Suffoletto, et al. 2011). For these reasons, the ED provides an opportunity to identify young adults with hazardous alcohol use and other risky behaviors. Unfortunately, most ED providers lack comfort, training and time to discuss sensitive topics like alcohol use with patients. Given these barriers, our multidisciplinary group of emergency physicians, addiction specialists and information technology experts developed a computerized system that conducts text message (SMS)-based dialogue with at-risk drinkers to assess weekend alcohol consumption and deliver motivational and educational support aimed at reducing binge episodes.

In 2012, we published our initial findings showing that our text message program is feasible, valid and reliable to communicate with at-risk young adults about alcohol use after ED care, and that this SMS program may be able to reduce binge drinking episodes in the short-term. Currently, The Foundation for Advancing Alcohol Responsibility in collaboration with the Emergency Medicine Foundation is funding our group to test both the immediate and lasting effect of our 12-week SMS program in at-risk young adults with hazardous drinking. Specifically, we will be randomizing 750 hazardous drinkers to our 12-week SMS intervention, SMS assessments or a control group who get no text messages. We will be examining the effect of the SMS intervention on both number of binge episodes as well as drinking-related injuries such as falls and fights at 3-, 6- and 9-months.

Since November 1st, 2013, we have screened over 600 young adults for past hazardous drinking behavior who presented to one of our three EDs in Pittsburgh. We have enrolled 198 participants and collected over 933 weekends of alcohol consumption data. In the SMS intervention group, we have preliminary findings suggesting that most binge episodes are planned events, and therefore modifiable. We also have preliminary findings suggesting that pre-weekend goal-setting reduces the likelihood of a binge episode. If found to be effective, the automated nature and low-cost of the SMS intervention would allow widespread deployment to reduce the harms associated with binge drinking among young adults.

Based on the results from his initial research, The Foundation for Advancing Alcohol Responsibility awarded a second grant to Dr. Suffoletto to conduct an expanded longitudinal mobile phone intervention trial among young adults at three emergency departments.