Objective: To examine the impact of usual drinking patterns and related problems on the
acute use or alcohol in injury. Methods: The impact of quantity and frequency of drinking,
alcohol problems and dependence symptoms on admission to the emergency room (ER) for an
alcohol-related injury (based, separately, on a positive BAC and self-reported drinking within six
hours prior to injury) compared to a non-alcohol related injury was examined using meta-analysis,
across 15 ER studies covering seven countries. Results: Pooled effect size for consuming 5 or
more drinks on an occasion at least monthly was significant but not homogeneous, with odds
ratios of 4.02 for BAC and 3.88 for self-report. Frequency of drinking among non-heavy
drinkers was found to have the largest effect size (5.65 for BAC and 4.83 for self-report), while
heavy drinking, controlling for frequency, was also significant (odds ratios of 2.07 for BAC and
1.86 for self-report), but effect size was homogeneous only for self-report. Alcohol-related
problems and dependence symptoms were also significant with odds ratios of 4.15 and 3.47,
respectively, for BAC and 3.73 and 3.76, respectively, for self-report. In meta-regression
analysis, among contextual variables, the level to which alcohol use is stigmatized in the culture
was most consistently predictive of heavy drinking effect size on an alcohol-related injury, with
larger effect sizes found in those studies reporting a lower level of stigmatization. Conclusions:
While quantity and frequency of drinking were both found to be highly predictive of an alcohol related
injury, socio-cultural variables may affect observed associations of heavy drinking with an
alcohol-related injury.