Contribution of Substance Use in Acute Injuries With Regards to the Intent, Nature and Context of Injury: A CHIRPP Database Study

Michaud-Germain, Catherine; Tardif, Pier‐Alexandre; Nadeau, Alexandra; Gagnon, Ann-Pier; Mercier, Éric

doi:10.7759/cureus.10282

Cited by 7 publications

(11 citation statements)

References 22 publications

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“…Prior to the suicide attempt, visits were primarily for behavioral health or substance abuse problems in the ED [25]. Interventions that consider the unique characteristics of older adults, such as the burden of chronic and debilitating physical injuries, might be more useful than general interventions.…”

Section: Discussionmentioning

confidence: 99%

Characteristics of Older Adults Attending the Emergency Department for Suicidal Thoughts or Voluntary Intoxication: A Multicenter Retrospective Cohort Study

Boulet¹,

Gagnon²,

Nadeau³

et al. 2022

Cureus

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The objective of this article is to explore the characteristics of older adults visiting the ED for suicidal thoughts and/or voluntary intoxication. MethodsAll older adults (65 years or older) who visited one of the five University Hospital Center (CHU) of Quebec EDs in 2016 and who reported suicidal thoughts or intoxication in triage or received a relevant discharge diagnosis were included. ResultsA total of 478 ED visits were identified, of which 332 ED visits (n=279 patients) were included. The mean age was 72.6 (standard deviation 6.8) years old and 41.6% were female. Mood disorders (41.2%) and alcoholism (40.5%) were common. Nearly 30% of all ED visits (n=109) resulted in a referral for a mental health assessment. In the subsequent year (2017), 38.4% returned to the ED for suicidal ideations. There were 7.9% who attended the ED five times or more. ConclusionsED visits for suicidal thoughts and intoxication in older adults are common among men with known mood disorders or alcoholism. ED dispositions are variable, and access to a mental health assessment is not consistent.

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Section: Discussionmentioning

confidence: 99%

Characteristics of Older Adults Attending the Emergency Department for Suicidal Thoughts or Voluntary Intoxication: A Multicenter Retrospective Cohort Study

Boulet¹,

Gagnon²,

Nadeau³

et al. 2022

Cureus

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“…16 17 Additionally, an investigation of the Canadian Hospitals Injury Reporting and Prevention Program found that alcohol and drug use were more frequently associated with intentional injuries compared with unintentional injuries; the investigation also found that trauma survivors presenting with alcohol and drug use were more likely to be younger and male. 18 Literature review revealed few trauma center-based investigations that have assessed the association between PTSD and alcohol and drug use comorbidities in injured patients. One prior investigation at a single level I trauma center found that among 878 randomly sampled hospitalized injury survivors, approximately 80% presented with either elevated PTSD symptom levels and/or alcohol, opioid, stimulant, and marijuana comorbidities.…”

Section: Open Accessmentioning

confidence: 99%

“…Other single-site investigations have found that trauma survivors of younger age, Caucasian race and male sex were more likely to be suffering from alcohol and drug use comorbidity 16 17. Additionally, an investigation of the Canadian Hospitals Injury Reporting and Prevention Program found that alcohol and drug use were more frequently associated with intentional injuries compared with unintentional injuries; the investigation also found that trauma survivors presenting with alcohol and drug use were more likely to be younger and male 18…”

Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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Post-traumatic stress disorder (PTSD) symptoms and alcohol and drug use comorbidity at 25 US level I trauma centers

Nguyen

Whiteside

Bulger

et al. 2022

Trauma Surg Acute Care Open

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BackgroundQuestions regarding the extent to which post-traumatic stress disorder (PTSD) is comorbid with alcohol and drug use are particularly germane in an era when the American College of Surgeons Committee on Trauma (ACS-COT) is considering policy requiring screening, intervention and/or referral services for patients presenting with psychological sequalae of traumatic injury. Literature review revealed few multisite trauma-center-based investigations that have assessed the association between PTSD symptoms and alcohol and drug use comorbidities in injured patients.MethodsThis investigation was a secondary analysis of baseline data collected prior to randomization in a 25-site trauma center pragmatic clinical trial. All 635 patients included in the investigation had elevated PTSD symptom levels at the time of trauma center admission. Self-report questionnaire screening, laboratory toxicology results, and electronic health record data were combined to assess the frequencies of alcohol, stimulant (i.e., amphetamine and cocaine), opioid and marijuana use comorbidities for injured patients. Logistic regression was used to assess the associations between demographic and injury characteristics and alcohol and drug use comorbidity.ResultsThe frequency of patients with one or more alcohol or substance use comorbidity was between 62% and 79%. Over 50% of patients were positive for one or more alcohol or cannabis comorbidity. Approximately 26% of patients were positive for stimulants and 10% for opioid comorbidity.DiscussionThis multisite investigation suggests that between 62% and 79% of hospitalized injury survivors with elevated PTSD symptoms have one or more alcohol or drug use comorbidity. Orchestrated ACS-COT policy and trauma center service delivery development should incorporate the key finding that a substantial majority of patients with high levels of psychological distress (eg, elevated PTSD symptoms) may have alcohol and drug use comorbidities.Level of evidenceLevel II (epidemiological investigation of untreated controls from a multisite randomized clinical trial)Trial registration numberNCT02655354.

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“…Studies have shown that traumatic injuries are often associated with substance abuse [8][9][10]; however, the patterns of substance abuse and the associated trauma mechanism have not been fully understood. The emergency department (ED) has evolved into the de facto treatment site for substance abuse presentations; it can serve as public health surveillance resource for substance abuse and traumatic injuries.…”

Section: Introductionmentioning

confidence: 99%

Prevalence of Substance Abuse Among Trauma Patients in Rural West Virginia

Mansoor¹,

Goncalves²,

Lakhani³

et al. 2023

Cureus

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Background: Substance abuse poses considerable clinical, economic, and social challenges. West Virginia is hailed as the epicenter of the substance abuse in the United States, the prevalence and pattern of different trauma mechanisms in a rural context or in patients with different forms of substance abuse remain unclear.Objective: We performed the following analysis to understand the prevalence of substance abuse in patients with different trauma mechanisms in the rural setting with high substance abuse in the West Virginia.Methods: We performed a cross-sectional retrospective analysis of adult trauma patients (motor vehicle, fall, assault, firearm suicide, brawl/rape and machinery) hospitalized in two tertiary care hospitals in West Virginia between 2006 and 2016. We identified all patients who had a urine drug screen (UDS) test and extracted the data related to the substance and trauma.Results: Among 8734 patients screened using UDS, 5940 (68.1%) patients were tested positive for the substance. Opiates, alcohol, benzodiazepines, and cannabis were the four most common substances identified in trauma victims. In all instances, the prescribed drug was less than 20%. Fatal outcome was observed in 366 patients in the sample, with 44% (n=162) testing positive for UDS, 12% (n=45) testing positive for only alcohol, and 15% (n=56) testing positive for both alcohol and UDS. Regarding the trauma mechanism, the motor vehicle accident (MVA) was the most prominent with a clear association of substance abuse with fatal outcome. Conclusion:The most prevalent trauma mechanism was a MVA, with a strong link between drug usage and mortality. Due to the high incidence of positive substance abuse screens, UDS tests may need to be more widely implemented in trauma in the West Virginia region. The findings of this study might help in establishing regional or national policies to reduce acute substance abuse.

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Contribution of Substance Use in Acute Injuries With Regards to the Intent, Nature and Context of Injury: A CHIRPP Database Study

Abstract: Michaud-Germain et al. This is an open access article distributed under the terms of the Creative Commons Attribution License CC-BY 4.0., which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Cited by 7 publications

References 22 publications

Characteristics of Older Adults Attending the Emergency Department for Suicidal Thoughts or Voluntary Intoxication: A Multicenter Retrospective Cohort Study

Characteristics of Older Adults Attending the Emergency Department for Suicidal Thoughts or Voluntary Intoxication: A Multicenter Retrospective Cohort Study

Post-traumatic stress disorder (PTSD) symptoms and alcohol and drug use comorbidity at 25 US level I trauma centers

Prevalence of Substance Abuse Among Trauma Patients in Rural West Virginia

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