title: Marijuana use and prior injury among injured problem drinkers.
abstract: OBJECTIVE
  The purpose of this paper is to better understand marijuana use among injured problem drinkers in the emergency department (ED). The specific objectives are: 1) to assess the prevalence of marijuana use; 2) to identify factors associated with marijuana use; 3) to determine whether prior injury is associated with marijuana use; and 4) to determine whether marijuana-using problem drinkers want to change behaviors.
  
  
  METHODS
  The authors conducted a post-hoc analysis on data obtained prospectively. Subjects had injury and problem drinking: either measurable alcohol level (blood alcohol concentration, BAC), report of drinking, or an Alcohol Use Disorders Identification Test (AUDIT) score of > or =8. The study was conducted on weekend nights; 3,776 injured ED patients were screened, 383 refused, 578 were enrolled, and 433 had complete data.
  
  
  RESULTS
  Of the 433 subjects, 48.3% reported using marijuana in the three months prior. Marijuana-using problem drinkers had more hazardous drinking, higher AUDIT scores (14.0 vs. 11.4, p < 0.001), and higher risk-taking scores (12.4 vs. 10.1, p < 0.001). More used other drugs (69.7% vs. 30.3%, p < 0.001). In regression analyses, marijuana use remained an independent predictor of prior injury (OR = 2.16, 95% CI = 1.25 to 3.75), particularly prior alcohol-related (OR = 2.26, 95% CI = 1.45 to 3.53) and motor-vehicle-related (OR = 1.69, 95% CI = 1.03 to 2.79) injury. Readiness-to-change scores were similar (4.14 vs. 4.22, p = 0.21) between users and nonusers.
  
  
  CONCLUSIONS
  Marijuana use among injured problem drinkers is prevalent. Their risk of prior injury is increased. Counseling for alcohol and injury should address marijuana use.
authors.affiliation: Brown University Medical School, Providence, RI 02903, USA. rwoolard@lifespan.org
authors.forename: Robert
authors.initials: R
authors.lastname: Woolard
authors.forename: Ted D
authors.initials: TD
authors.lastname: Nirenberg
authors.forename: Bruce
authors.initials: B
authors.lastname: Becker
authors.forename: Richard
authors.initials: R
authors.lastname: Longabaugh
authors.forename: P Allison
authors.initials: PA
authors.lastname: Minugh
authors.forename: Aruna
authors.initials: A
authors.lastname: Gogineni
authors.forename: Kathleen
authors.initials: K
authors.lastname: Carty
authors.forename: Patrick R
authors.initials: PR
authors.lastname: Clifford
mesh_terms: D000328:Adult; D000437:Alcoholism / Q000150:complications / Q000453:epidemiology* / Q000523:psychology; D004522:Educational Status; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008385:Marijuana Smoking / Q000453:epidemiology*; D017533:Marital Status; D015995:Prevalence; D011446:Prospective Studies; D011614:Psychotherapy, Brief; D019966:Substance-Related Disorders / Q000150:complications*; D011795:Surveys and Questionnaires; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology