Brief Intervention and Fibroscan for Harmful Drinkers Presenting to the Emergency Department

The investigators plan to assess the feasibility of a randomised controlled trial of an innovative screening (Identification), Brief Intervention, Fibroscan and Self-Referral for Specialist Treatment (IBAFiRST) programme for high risk drinkers in the Emergency Department (ED). IBAFiRST extends existing screening and advice given to people with potential alcohol use disorders (AUD) in ED. Currently patients who drink heavily have brief advice and are asked to refer themselves to community specialist alcohol treatment services (ATS) after leaving ED. A Fibroscan is a safe, quick and reliable ultrasound test to see if there are signs of "stiffening" of the liver which can indicate early liver damage. It is recommended as a non-invasive test by the National Institute for Health and Care Excellence (NICE) but is not known to be used within EDs in the UK. The investigators wish to test whether giving the patients the results of this scan will make them more likely to self-refer to ATS. Currently take up rates of ATS are low in this population and too few people are seeking treatment to help them reduce their alcohol intake. Because so little is known about self-referral in ED the investigators are completing a feasibility study before seeking funding for a large scale randomised trial.

Inclusion Criteria:Has capacity to give informed consentHave no urgent or life-threatening illness or injuryHave not eaten a larger meal within 3 hours of trial enrollmentAnswer "yes" to a single item alcohol screening question (standard care)Score of 11 or 12 on the Audit-C alcohol screening toolExclusion Criteria:They are unable or unwilling to undertake single-question screening (standard care)They refuse or lack capacity to give informed consent to trial inclusionThey are living in postcodes outside of the catchment areas for Nottingham City or Nottingham County community alcohol treatment servicesThey have an urgent or life-threatening illness or injuryTheir treating clinician thinks there is any other reason that they would not benefit from trial inclusion