Drug Use and Abuse in an Urban Veteran Spinal Cord Injured Population

Abstract

Substance abuse in the spinal cord injured (SCI) population has been addressed in a few controlled studies. These reports have led to the belief that many SCI patients were illicit drug users prior to their injury and that their drug abuse was a contributing cause of their accidents. One large study determined from answers obtained on a questionnaire that drug abuse, other than alcohol, was prevalent among injured veterans. Our study uses urine toxicology to determine the frequency of drug use and abuse, excluding alcohol, in 72 inpatients and 81 outpatients associated with an urban Veterans Affairs Medical Center. In a blinded experiment, urinary concentrations of opiates, barbiturates, amphetamines, methadone, benzodiazepines, and cocaine were determined with Syva reagents on an Abbott VP. Urinary cannabinoids were determined using Abbott TDX and the FPIA method. The use of illicit (unprescribed) drugs was surprisingly low (< or = 13 percent) for an urban medical center. Outpatient cannabinoid abuse was significantly more frequent than inpatient usage (p < 0.01). Barbiturates were not found in any patient. Benzodiazepines were taken most commonly (29 percent). Since benzodiazepine usage is the direct result of physician prescription, wide-spread usage of this agent is avoidable. Physicians should pay attention to the probable deleterious consequences of benzodiazepine addiction related to depressive effects on the central nervous system caused by its chronic use.

Preinjury alcohol and drug use among persons with spinal cord injury: Implications for rehabilitation

“…26 The results of this study are also consistent with other studies assessing alcohol problems among consecutive inpatients with SCI. 1,3,16,17 Interestingly, rates of significant alcohol problems based on self-reports of consecutive inpatients appear much higher than estimates based on community surveys. Young et al 4 surveyed 123 community residents with SCI and found that 21% of respondents reported significant alcohol-related problems based on their SMAST scores.…”

“…Several studies of preinjury alcohol and drug use have reported data based on admission toxicology screens or serum alcohol levels, with positive blood alcohol levels (BALs) ranging from 40 to 44% and positive drug toxicology screens ranging from 27 to 35%. 1,3,16,17 However, many estimates of drug use based on toxicology screens may have limited validity because they screen for presence of opiates or benzodiazepines. These drugs are often administered in emergency medical treatment and may represent a possible confound.…”

Lesión medular y uso de sustancias: una revisión sistemática

“…En general, hay una amplia variedad de metodologías y variables medidas entre estudios. Gran parte de la literatura se centraba en la medición de ingesta de alcohol o de alcoholemias (Furlan y Fehlings, 2013;McKinley et al, 1999;Rothstein, Levy, Fecher, Gordon, y Bauman, 1992;Stroud et al, 2011;Turner et al, 2003). Varios estudios evaluaron tabaco y otras sustancias legales (p.…”

Characteristics of Tranquilizer Use among Australian Vietnam War Veterans

“…Rothstein et al 11 examined the frequency of drug use and abuse in over 150 patients from a Veterans Affairs Medical Center in the US. Urinary concentrations of various drugs were determined in a blinded fashion, with the investigators finding that the use of nonprescribed drugs was surprisingly low.…”