Predictors of violence following Emergency Department visit for cocaine-related chest pain.
This study examined 1-year violence outcomes among non-injured patients treated in the Emergency Department (ED) for cocaine-related chest pain. An urban Level I ED required patients with chest pain (age 60 and younger) provide a urine sample for cocaine testing. Cocaine-positive consenting patients (n=219) were interviewed in the ED; 80% completed follow-up interviews over 12-months (n=174; 59% male, 79% African-American, mean age=38.8, standard deviation 9.06; range=19-60). Baseline rates of past year violent victimization and perpetration history were: 38% and 30%, respectively. During the 12-month follow-up, rates of victimization and perpetration outcomes were 35% and 30%, respectively. Predictors of violence outcomes (either victimization or perpetration) in the year post-ED visit based on characteristics were measured at baseline or during the follow-up period (i.e., gender, age, psychological distress, binge drinking days, cocaine use days, marijuana use days, substance abuse/dependence diagnosis, victimization/perpetration history). Victimization during the follow-up was related to younger age, more frequent binge drinking and marijuana use at baseline, and victimization history, and to substance abuse/dependence, more frequent binge drinking, and psychiatric distress at follow-up. Specifically, participants who reported victimization at baseline were approximately 3 times more likely to report victimization at 12-month follow-up. Perpetration during the follow-up was related to younger age and more frequent binge drinking at baseline, and to substance abuse/dependence, more frequent binge drinking, and psychiatric distress at follow-up. Overall, no significant gender differences were observed in violence; however, women were more likely than men to report injury during the most severe partner violence incident. Violence is a common problem among patients presenting to an inner-city ED for cocaine-related chest pain, with younger age and frequency of binge drinking being a consistent marker of continued violence involvement. Intervention approaches to link these not-in-treatment cocaine users to services and reduce cocaine use must take into account concomitant alcohol misuse and violence.
Walton
Maureen A
MA
Department of Psychiatry, University of Michigan, Ann Arbor, MI 48105, United States. waltonma@umich.edu
Cunningham
Rebecca
R
Chermack
Stephen T
ST
Tripathi
Shanti
S
Weber
James
J
Maio
Ronald F
RF
Booth
Brenda M
BM
D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000367:Age Factors; D000437:Alcoholism / Q000150:complications / Q000453:epidemiology; D002637:Chest Pain / Q000453:epidemiology / Q000209:etiology* / Q000628:therapy*; D003042:Cocaine / Q000009:adverse effects*; D019970:Cocaine-Related Disorders / Q000150:complications* / Q000453:epidemiology / Q000523:psychology*; D019548:Crime Victims; D004632:Emergency Medical Services; D004636:Emergency Service, Hospital; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D002189:Marijuana Abuse / Q000150:complications / Q000453:epidemiology; D008875:Middle Aged; D012307:Risk Factors; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014754:Violence / Q000523:psychology* / Q000706:statistics & numerical data; D055815:Young Adult
D003042:Cocaine