title: Psychoactive substance dependence among trauma center patients.
abstract: 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.
authors.affiliation: Department of Surgery, R Adams Cowley Shock Trauma Center, Maryland Institute for Emergency Medical Services Systems, Baltimore 21201-1595.
authors.forename: C A
authors.initials: CA
authors.lastname: Soderstrom
authors.forename: P C
authors.initials: PC
authors.lastname: Dischinger
authors.forename: G S
authors.initials: GS
authors.lastname: Smith
authors.forename: D R
authors.initials: DR
authors.lastname: McDuff
authors.forename: J R
authors.initials: JR
authors.lastname: Hebel
authors.forename: D A
authors.initials: DA
authors.lastname: Gorelick
mesh_terms: 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*
chemical_list: D011619:Psychotropic Drugs; D000431:Ethanol