title: Psychoactive substance (drugs and alcohol) use by Emergency Department patients before injury.
abstract: OBJECTIVE
  The aim of this study was to determine the prevalence and risk factors of alcohol, medication and illicit drug use before accidents in Emergency Department (ED)-treated trauma victims with internationally recommended methods to minimize registration bias.
  
  
  METHODS
  The study design was cross-sectional and was carried out at Erasmus Medical Centre in Rotterdam. Alcohol, psychoactive medication and illicit drug use were assessed in an interview by an independent researcher on the basis of the standardized WHO questionnaire. During 84 shifts, covering 4 weeks 24/7, data on a comprehensive population of ED-treated injury patients were collected prospectively.
  
  
  RESULTS
  A total of 475 patients were included (response rate 87%). The prevalence of alcohol intoxication (defined as ≥3 U alcohol) before trauma was 19%. Alcohol-intoxicated trauma patients were significantly more often men [odds ratio (OR) 2.88, 95% confidence interval (CI) 1.54-5.40], of Dutch descent (native) (OR 2.26, 95% CI 1.24-4.13), unemployed or students (OR 1.77, 95% CI 1.03-3.04), and alcohol intoxication decreased with age (OR 0.98, 95% CI 0.96-0.99). Psychoactive medication was used by 7% of ED trauma patients; increasing age (OR 1.05, 95% CI 1.03-1.07) and living alone (OR 2.4, 95% CI 1.04-5.52) were risk factors. Illicit drugs were used by 4% of trauma patients. Overall, 27% of patients were under the influence of at least one psychoactive substance.
  
  
  CONCLUSIONS
  Over a quarter of trauma patients visiting the ED had used alcohol, psychoactive medication and/or illicit drugs before their accident. By far, the majority of intoxications before trauma were because of alcohol (19%). We found higher prevalence rates of alcohol intoxication and lower prevalence rates for illicit drug use than others. Because of our comprehensive approach and high response rates, registration bias was minimized.
authors.affiliation: Departments of aEmergency Medicine bPublic Health cSurgery - Trauma Research Unit, Erasmus Medical Centre dIVO Addiction Research Institute Rotterdam eDepartment of Health Promotion, University of Maastricht, Maastricht, The Netherlands fDepartment of Emergency Medicine, University of Maryland School of Medicine, Baltimore, Maryland, USA.
authors.forename: Pleunie P M
authors.initials: PP
authors.lastname: Rood
authors.forename: Juanita A
authors.initials: JA
authors.lastname: Haagsma
authors.forename: Suzanne
authors.initials: S
authors.lastname: M Boersma
authors.forename: Andrea
authors.initials: A
authors.lastname: Tancica
authors.forename: Esther M M
authors.initials: EM
authors.lastname: Van Lieshout
authors.forename: Terrence
authors.initials: T
authors.lastname: Mulligan
authors.forename: Dike
authors.initials: D
authors.lastname: Van De Mheen
authors.forename: Ed F
authors.initials: EF
authors.lastname: Van Beeck
authors.forename: Peter
authors.initials: P
authors.lastname: Patka
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects* / Q000453:epidemiology; D000435:Alcoholic Intoxication / Q000150:complications / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D015995:Prevalence; D011619:Psychotropic Drugs / Q000009:adverse effects*; D012307:Risk Factors; D019966:Substance-Related Disorders / Q000150:complications* / Q000453:epidemiology; D014947:Wounds and Injuries / Q000209:etiology*; D055815:Young Adult
chemical_list: D011619:Psychotropic Drugs