Post-discharge alcohol-related emergency department use among older adults following involuntary inpatient treatment for alcohol use disorder.

ObjectiveThe New South Wales Involuntary Drug and Alcohol Treatment (IDAT) program provides last-resort involuntary inpatient treatment for severe substance dependence. This study described older adults with severe alcohol use disorder (AUD) admitted to IDAT and their alcohol-related emergency department (ED) use after discharge.MethodsThis retrospective cohort study included patients aged ≥60 years with primary AUD admitted to an IDAT unit during 2016-2022. Demographic, social and clinical variables were summarised. Alcohol-related ED presentations before admission and after discharge were compared; time to first post-discharge presentation was examined using Kaplan-Meier analysis.ResultsOf 374 admissions, 37 older adults met inclusion criteria. Medical and psychiatric comorbidity, living alone and residence outside major cities were common. Among 36 participants included in post-discharge analyses, alcohol-related ED presentations were lower in the 6 months after discharge than in the 6 months before admission (median 1 vs 3, P < 0.001). Within 6 months, 22 participants (61%) re-presented, of whom 18 (82%) first re-presented within 3 months.ConclusionsOlder adults admitted to IDAT for severe AUD formed a clinically and socially complex cohort. Alcohol-related ED re-presentations were concentrated within 3 months of discharge, highlighting a high-risk transition period requiring structured continuity of care.