Psychoactive substance dependence among trauma center patients.
BACKGROUND
The practice of assessing only trauma patients with elevated blood alcohol concentrations (BACs) or positive drug screens for psychoactive substance use disorders (PSUDs) was evaluated.


METHODS
Twenty-four BAC-negative (BAC-) (BAC, 0) and 21 BAC-positive (BAC+) (BAC, greater than or equal to 22 mmol/L or 100 mg/dL; mean, 41 mmol/L; range, 24.3 to 79 mmol/L) adult trauma patients were evaluated for alcoholism and other PSUDs using the Structured Clinical Interview (SCI) from the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R). Approximately half were vehicular crash victims and 78% were men.


RESULTS
A total of 64 PSUDs were diagnosed in 31 (68.9%) of the 45 patients; all but one was for dependence (vs abuse). Of the BAC+ patients, 14 (66.7%) met DSM-III-R criteria for alcohol dependence, 11 (78.6%) of whom also had other PSUDs not related to alcohol. Two other BAC+ patients had nonalcohol PSUDs. Of the BAC- patients, 11 (45.8%) had alcohol dependence, six (54.5%) of whom also had nonalcohol PSUDs. Another four BAC- patients had nonalcohol PSUDs. Overall, 76.2% of the BAC+ patients and 62.5% of the BAC- patients had a diagnosis of psychoactive substance dependence.


CONCLUSIONS
All patients admitted to trauma centers should be assessed for alcoholism and other PSUDs.
Soderstrom
C A
CA
Department of Surgery, R Adams Cowley Shock Trauma Center, Maryland Institute for Emergency Medical Services Systems, Baltimore 21201-1595.
Dischinger
P C
PC
Smith
G S
GS
McDuff
D R
DR
Hebel
J R
JR
Gorelick
D A
DA
D000437:Alcoholism / Q000097:blood / Q000150:complications / Q000453:epidemiology; D000431:Ethanol / Q000097:blood; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008396:Maryland / Q000453:epidemiology; D010865:Pilot Projects; D015995:Prevalence; D011619:Psychotropic Drugs / Q000097:blood*; D019966:Substance-Related Disorders / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000453:epidemiology*; D014193:Trauma Centers; D014947:Wounds and Injuries / Q000209:etiology*
D011619:Psychotropic Drugs; D000431:Ethanol