Alcohol disorders among patients with burns: crisis and opportunity.

A burn injury so severe that inpatient treatment is necessary is a crisis in any patient's life. For patients who also suffer from an alcohol use disorder, hospitalization may offer a unique opportunity to facilitate entry into appropriate treatment. In this study, 442 hospitalized patients with burns were evaluated, and 50 (11%) were diagnosed with an alcohol use disorder by DSM-III-R criteria. All but one of the injuries were deemed preventable. The average length of stay in hospital was 9 days longer for the alcohol group compared with the average stay in the burn center, resulting in additional costs of $337,500. Referral for treatment of the underlying alcohol disorder was recommended for fewer than half the patients. Thus, although the patients with alcohol use disorders had lengthy hospitalizations and were in circumstances that might permit the characteristic denial of alcoholism to be relinquished, the treatment team usually did not capitalize on this opportunity.