Substance abuse in adolescent trauma

Loiselle, John M.; Baker, M. Douglas; Templeton, John Y.; Schwartz, Gary; Drott, Henry R.

doi:10.1016/s0196-0644(05)81253-3

Cited by 70 publications

(29 citation statements)

References 11 publications

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“…Previous toxicological studies included prevalence studies in seriously injured trauma patients presenting to a trauma centre, 10 11 trauma patients with altered levels of consciousness, 12 drivers under arrest, 13 and RTA fatalities. 14 The prevalence rates of a selected number of applicable studies, including one adolescent study, 15 are shown in table 1.…”

mentioning

confidence: 99%

Toxicological screening in trauma

Carrigan

2000

Emergency Medicine Journal

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Objectives-To determine the prevalence and patterns of alcohol and drug use in patients with major trauma. Methods-Consecutive trauma patient enrolment, 24 hours a day, was envisaged with anonymised patient data on gender, age band, and mechanism of injury collected. The study group had surplus plasma quantitatively analysed for ethanol concentration, and urine samples were initially screened, via immunoassay, for opiates, cannabinoids, amphetamines, benzodiazepines, cocaine, and methadone. Confirmation and specification of individual positive results was then performed using thin layer or gas-liquid chromatography. Drugs of treatment given in the resuscitation room, if subsequently detected in the urine samples, were excluded from the final results. Results-There were 116 eligible trauma patients assessed and treated in the resuscitation room over a six month period, of which 93 (80%) were enrolled. Altogether 27% of this trauma population had plasma ethanol concentrations greater than 80 mg/dl. There was a significantly higher prevalence of alcohol intoxication in the group not involved in a road traYc accident (RTA) compared with the group who were involved in a RTA.Initial screening of urine for drugs revealed a prevalence of 51%. After 12 exclusions due to iatrogenic administration of opiates, the final confirmed prevalence was 35% in this trauma population. The individual drug prevalence was 13% for cannabinoids, 11% for codeine, 8% for morphine, 6% for amphetamine, 6% for benzodiazepines, 3% for cocaine, 1% for dihydrocodeine, and 1% for methadone. Conclusions-There is a notable prevalence of drug and alcohol use in this British accident and emergency trauma population.A significantly higher prevalence for alcohol intoxication was found in the non-RTA group compared with the RTA group.The patterns of drug usage detected reflect local influences and less cocaine use is seen compared with American studies. The association between alcohol, drugs, and trauma, together with ethically acceptable methods of screening, are discussed. (J Accid Emerg Med 2000;17:33-37)

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confidence: 99%

Toxicological screening in trauma

Carrigan

2000

Emergency Medicine Journal

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“…For instance, in the US substance misuse (alcohol or drugs) has been reported as commonly associated in teenagers with presentations in accident and emergency departments or trauma admissions (e.g. Loiselle, 1993;Mannenbach, 1997;Spain, 1997). Recommendations have been made to use screening more and subsequently refer those positive to appropriate services (Maio, 1994;Buchfurer & Radecki, 1996).…”

Section: Discussionmentioning

confidence: 99%

Risky presentations

Subotsky

Santhouse

2000

Psychiatr. bull.

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Aims and MethodsThe aim was to review the assessment and management of the psychosocial risk (including substance misuse) of older children presenting to the accident and emergency department, with a view to making recommendations to improve services. The method used was to inspect casualty records of attendances over two weeks of 11-16-year-olds.ResultsIn no cases was any note made of whether substance misuse might have occurred. Cases of apparent psychosocial risk were, however, dealt with appropriately in the main.Clinical ImplicationsBrief advisory guidelines were written for accident and emergency staff to promote consideration of the misuse of substances in older children, and an information leaflet was developed for young people and their parents.

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“…The youth admitted for assault-related injuries were most likely to be positive for substance use, with a surprising 49% of the youth having behavioral evidence of chronic alcohol abuse. Similarly, Loiselle et al [31] found that recent use of alcohol was more common among adolescents treated for intentional injury than those treated for unintentional injury. Finally, Murphy et al [34] found that more than half (55%) of adolescents presenting at inner-city trauma centers with facial injuries had problem levels of substance use.…”

Section: Substance Use and Injury Among Adolescentsmentioning

confidence: 95%

“…Of all 13 to 19 year olds admitted to a Level I Pediatric Trauma Center, 34% screened positive for alcohol or drugs on admission. [31] Another study of adolescents admitted for trauma found that 48% had positive blood alcohol levels. [32] Rivara et al [33] found that 41% of 18 -20 year olds admitted for trauma had positive blood alcohol screens.…”

Section: Substance Use and Injury Among Adolescentsmentioning

confidence: 99%

Substance Use and Facial Injury

Murphy¹

2011

Perioperative Nursing Clinics

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Substance abuse in adolescent trauma

Cited by 70 publications

References 11 publications

Toxicological screening in trauma

Toxicological screening in trauma

Risky presentations

Substance Use and Facial Injury

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