Dangerous to your health: the role of chronic drug use in serious injuries and trauma.
OBJECTIVE
This study estimated the differential risks of serious injury or trauma for a community-based sample of chronic drug users (CDUs; n = 926) and a matched group of nondrug users (NDUs; n = 553). The study also estimated whether CDUs and NDUs differed in their utilization of health care services for serious injury or trauma.


METHODS
Data were collected in 1996 and 1997 through community outreach activities in Miami-Dade County, Florida. The analysis estimated the effects of drug use on (1) any lifetime serious injury or trauma, (2) any serious injury or trauma during the past 12 months, and (3) utilization of health care services for serious injury or trauma. All analyses were gender specific and the models were also estimated with a measure of problematic alcohol use in addition to CDU. To examine the potential endogeneity of drug use, various specification tests were conducted.


RESULTS
For females, CDUs experienced significantly more serious injury, trauma, or both (both lifetime and past year) than nonusers. Drug use status was not a significant predictor of serious injury or trauma (lifetime and past year) for males. Regardless of gender, conditional on experiencing any serious injury or trauma during the past year, CDUs and NDUs did not differ in their utilization of health care services. Various statistical tests determined that CDU was exogenous in all specifications and the findings were largely unchanged when problematic alcohol use was included in the models.


CONCLUSIONS
The elevated risk for serious injury or trauma for female CDUs renders these persons vulnerable to severe medical problems. Specific training in substance abuse issues may be necessary if health care providers are to identify, engage, knowledgeably serve, and refer CDUs for appropriate services.
Zavala
Silvana K
SK
Health Services Research Center and Department of Epidemiology and Public Health, University of Miami, Miami, Florida, USA. frenchm@musc.edu
French
Michael T
MT
D000328:Adult; D003625:Data Collection / Q000379:methods; D003627:Data Interpretation, Statistical; D005260:Female; D005431:Florida / Q000453:epidemiology; D006296:Health Services / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011336:Probability; D012067:Religion; D012737:Sex Factors; D019966:Substance-Related Disorders / Q000453:epidemiology*; D014947:Wounds and Injuries / Q000453:epidemiology*