An overview of injuries to adolescents and young adults related to substance use: data from Canadian emergency departments

Abstract

Objective: Alcohol is a significant risk factor for injury, and is one of the leading causes of death, disability and premature mortality among young Canadians. This paper provides an overview of alcohol-related injury among adolescents and young adults presenting to Canadian emergency departments (EDs). Methods: We reviewed records from the Canadian Hospitals Injury Reporting and Prevention Program database during the 4-year period between 2000 and 2003. We included individuals younger than 25 years who presented to EDs in 11 pediatric and general hospitals with injuries for which alcohol, either alone or in conjunction with drugs, was recorded as a contributing factor. We examined key socio-demographic and injury-related factors associated with alcohol and drugrelated injuries, including intent and disposition. Results: Alcohol was identified as a factor in 2389 injuries during this 4-year period; 408 (17%) of these cases also involved drug use. Approximately 55% of these patients were male and the majority was between 15 and 19 years of age. Unintentional injuries were the most common presentation, self-harm injuries were more common among female patients and violence-related injuries were more common among male patients. Most patients received treatment for their injuries. However, as age increased, outcome differences were observed between sexes. Conclusion: Alcohol-related injuries are increasing among Canadian youth. These findings highlight the importance of obtaining thorough drug and alcohol histories and measurement, when appropriate, for adolescents and young adults presenting to EDs with injuries.

The Association of Injury With Substance Use Disorder Among Women of Reproductive Age: An Opportunity to Address a Major Contributor to Recurrent Preventable Emergency Department Visits?

“…Broad studies of injury often lack specificity by gender and age. There is much information, for example, about falls in adolescents 33 and in older adults, 21,34 but very little about the combined effects of age, sex, SUD, and injury for women in the reproductive age group. National plans to drop the DAWN reporting mechanism for substance abuse and include SUD in the National Ambulatory Medical Care/Emergency Department Survey may provide a more robust data source in the future for measuring the association of SUD with injury on the national level.…”

Elevated depressive symptoms and adolescent injury: examining associations by injury frequency, injury type, and gender

“…Evidence has established the associations of certain social determinants with injury, [4-6] particularly among adults, such as gender, [7-9] socio-economic status, [7,8,10,11] rural/urban living, [12] and ethnicity and culture [13,14]. For instance, gender differences persist in injury rates with males being more likely than females to suffer serious injury, [7,8] suggesting male risk-taking propensity and participation in contact sport are possible explanations [9,10,15]. Among adolescents, however, female injury rates are often higher than males, particularly for suicide and self-harm related injury [9].…”

“…For instance, gender differences persist in injury rates with males being more likely than females to suffer serious injury, [7,8] suggesting male risk-taking propensity and participation in contact sport are possible explanations [9,10,15]. Among adolescents, however, female injury rates are often higher than males, particularly for suicide and self-harm related injury [9]. Similarly, ecological studies suggest that low socioeconomic status and neighbourhood disadvantage lead to higher rates of unintentional injury hospitalization [7,8].…”

“…Injury has also been linked with psychosocial risk factors, including alcohol and drug use [16], both of which increase the risk of unintentional (e.g. falls) and intentional injury (traffic crashes, violence and self-harm) [9,17-20]. …”

Reciprocal Effects of Internalizing and Oppositional Defiance Symptoms on Heavy Drinking and Alcohol-Related Harms in Young Adulthood

“…10 Given the persistent reciprocal relations observed here, early identification will be imperative for interrupting this cycle. Many youth present at emergency rooms as a result of over-consumption or injuries and other harms from drinking, 59 providing salient opportunities for screening of mental health symptoms. Additional screening could help catch youth whose subclinical symptoms go unnoticed in other settings, possibility disrupting this vicious cycle and ultimately helping to prevent more serious concerns including alcohol-related deaths, injuries, and suicides.…”