Epidemiology of Alcohol and Other Drug Use Among Motor Vehicle Crash Victims Admitted to a Trauma Center

The objectives of this research were to (1) determine the incidence and prevalence of alcohol and other drug use among motor vehicle crash (MVC) victims admitted to a regional Level-I trauma center, and (2) to examine the utility of using a rapid point-of-collection (POC) drug-testing device to identify MVC patients with drug involvement. Blood and urine specimens were routinely collected per clinical protocol for each MVC victim at the time of admission. Blood alcohol concentration (BAC) levels were determined per standard clinical protocol. Clinical urine specimens were routinely split so that a POC drug-testing device for the detection of commonly abused drugs (Marijuana, Cocaine, Amphetamines, Methamphetamines, and Opiates) could be compared to that of the standard hospital laboratory analysis of each urine specimen (which also included Barbiturates and Benzodiazepines). In the six-month period of this study, nearly two-thirds of trauma center admissions were victims of motor vehicle crashes. During this time, blood and urine was collected from 322 MVC victims. Toxicology results indicated that 59.3% of MVC victims tested positive for either commonly abused drugs or alcohol. More patients tested positive for drug use than tested positive for alcohol, with 33.5% testing positive for drug use only, 15.8% testing positive for alcohol use only, and 9.9% testing positive for both drugs and alcohol. Less than half (45.2%) of the substance-abusing patients in this study would have been identified by an alcohol test alone. After alcohol, marijuana and benzodiazepines were the most frequently detected drugs. Point of collection (POC) test results correlated well with laboratory results and provide important information to initiate rapid intervention/treatment for substance use problems among injured patients.

[1]  C. Cherpitel Drinking patterns and problems and drinking in the event: an analysis of injury by cause among casualty patients. , 1996, Alcoholism, clinical and experimental research.

[2]  A. Treno,et al.  Estimating alcohol involvement in trauma patients: search for a surrogate. , 1994, Alcoholism, clinical and experimental research.

[3]  C A Soderstrom,et al.  Alcoholism at the time of injury among trauma center patients: vehicular crash victims compared with other patients. , 1997, Accident; analysis and prevention.

[4]  Evelyn Vingilis,et al.  Review: Drugs and Traffic Collisions , 2002 .

[5]  A. Madan,et al.  Alcohol and drug use in victims of life-threatening trauma. , 1999, The Journal of trauma.

[6]  P. Dischinger,et al.  Epidemic increases in cocaine and opiate use by trauma center patients: documentation with a large clinical toxicology database. , 2001, The Journal of trauma.

[7]  J Mørland,et al.  Driving under the Influence of Non-Alcohol Drugs. , 2020, Forensic science review.

[8]  Eastman Ab,et al.  Resources for optimal care of the injured patient--1993. , 1994 .

[9]  H M Simpson,et al.  EPIDEMIOLOGY AND SPECIAL POPULATION SURVEYS , 1992 .

[10]  J M Walsh,et al.  DETECTION OF ILLICIT DRUGS IN DRIVERS , 1997 .

[11]  Licsw,et al.  Evaluating the effects of a brief motivational intervention for injured drinkers in the emergency department. , 2001, Journal of studies on alcohol.

[12]  D Shinar,et al.  STATE OF KNOWLEDGE OF DRUG-IMPAIRED DRIVING , 2003 .

[13]  M. Copass,et al.  The magnitude of acute and chronic alcohol abuse in trauma patients. , 1993, Archives of surgery.

[14]  R. Longabaugh,et al.  Injury as a motivator to reduce drinking. , 1995, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[15]  Federico Alvarez,et al.  ILLEGAL DRUGS AND DRIVING , 1995 .

[16]  J. Ramaekers,et al.  Pitfalls in estimating drug-related crash risk. , 2003, Trends in pharmacological sciences.

[17]  R. Woolard,et al.  Brief intervention for harm reduction with alcohol-positive older adolescents in a hospital emergency department. , 1999, Journal of consulting and clinical psychology.

[18]  M. Copass,et al.  Drug use in trauma victims. , 1989, The Journal of trauma.

[19]  P. Marquet,et al.  Prevalence of drugs of abuse in urine of drivers involved in road accidents in France: a collaborative study. , 1998, Journal of forensic sciences.

[20]  D. Linklater Alcohol and other drugs , 1979 .

[21]  L. Gentilello Alcohol interventions in a trauma center , 2001 .

[22]  P F Waller,et al.  Alcohol abuse/dependence in motor vehicle crash victims presenting to the emergency department. , 1997, Academic emergency medicine : official journal of the Society for Academic Emergency Medicine.

[23]  C A Soderstrom,et al.  Alcohol and other drugs: an assessment of testing and clinical practices in U.S. trauma centers. , 1994, The Journal of trauma.

[24]  W Vycudilik,et al.  Drugs and driving in Vienna, Austria. , 1998, Journal of forensic sciences.

[25]  M. Copass,et al.  Alcohol interventions in a trauma center as a means of reducing the risk of injury recurrence. , 1999, Annals of surgery.