title: Toxicology screening in acute spinal cord injury.
abstract: The validity of self-reported intoxication at time of spinal cord injury (SCI) was examined for 88 cases at admission to an acute SCI center by comparing self-reports with serum and urine analyses. Serum ethanol greater than 50 mg/dl was the most frequently found substance (observed in 40% of the cases) followed by urine analysis evidence of cocaine (14%), cannabinoids (8%), benzodiazipines (5%), and opiates (4%). Evidence of substances with abuse potential was found in urine for 35% of the sample. While 62% of the sample had either serum ethanol greater than 50 mg/dl or a positive urine analysis, only 42% of the sample reported being under the influence of some substance at the time of SCI. Although the relationship between these two measures was statistically significant, self-report and toxicology analyses were discordant in 34% of the cases. These results suggest that routine drug testing at admission to an SCI center will produce both false-negative and false-positive results if substance presence alone is interpreted as evidence of intoxication.
authors.affiliation: Rehabilitation Institute of Chicago, Illinois 60610.
authors.forename: A W
authors.initials: AW
authors.lastname: Heinemann
authors.forename: S
authors.initials: S
authors.lastname: Schnoll
authors.forename: M
authors.initials: M
authors.lastname: Brandt
authors.forename: R
authors.initials: R
authors.lastname: Maltz
authors.forename: M
authors.initials: M
authors.lastname: Keen
mesh_terms: D000293:Adolescent; D000328:Adult; D000437:Alcoholism / Q000097:blood / Q000150:complications*; D000431:Ethanol / Q000493:pharmacokinetics*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011619:Psychotropic Drugs / Q000493:pharmacokinetics*; D012307:Risk Factors; D013119:Spinal Cord Injuries / Q000097:blood*; D019966:Substance-Related Disorders / Q000097:blood / Q000150:complications*
chemical_list: D011619:Psychotropic Drugs; D000431:Ethanol