The Emergency Room Psychiatric Social Worker's Role in Substance Use Assessment

Substance use is always a hot topic in the ER setting. As a clinician, the assessment of substance use issues in the patient is paramount, especially when there is a previous family history of substance use. We evaluate the age of onset when they began experimenting with drug use. It is crucial in understanding the patterns of use, whether they use illicit substances to self-medicate or to avoid problems, which can lead to an addiction.

It is especially interesting to see the changes over the years with regard to drug treatment, especially with the legalization, in some states, of marijuana and the ongoing abuse of PCP, ecstasy, heroin, cocaine, opiates, benzodiazepines, and over the counter medications, and people buying prescription drugs on the streets.

Our experience in the ER via patients’ reports is that they utilize certain prescription drugs to help counteract the effects of the illicit drugs they abuse. It is helpful to be aware of a drug’s street name as well. You can actually obtain this information with the help of the Internet and the patients’ verbal reports. This is a consistent part of our psychiatric evaluation in the ER, as it allows us to fully understand the comorbidities and the effects these drugs have on the brain, especially for those with preexisting psychiatric disorders.

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