Influence of alcohol and other substances of abuse at the time of injury among patients in a Norwegian emergency department.
The presence of alcohol or other substances of abuse in blood or urine from injured patients is often used as a proxy for substance influence at the time of injury. The aim of this study was to obtain an estimate of substance influence at the time of injury based on blood concentrations of alcohol and other substances of abuse, and to explore the relationship between the substance prevalence at the time of admittance to the hospital and the actual influence at the time of the injury.



The study included all adult patients admitted to the emergency department of a university hospital during 1 year (n = 996). Quantification in blood was done by an enzymatic method for alcohol, and by liquid chromatography-mass spectrometry or gas chromatography-mass spectrometry for 28 other substances of abuse. Concentrations of alcohol and other substances in blood at the time of injury were calculated. The degree of influence was assessed on the basis of the calculated blood concentrations, with a threshold of influence set at a blood alcohol concentration (BAC) of 0.05 %, or a substance concentration leading to an influence similar to that of a BAC of 0.05 %.



A total of 324 patients (32.5 %) were determined to be under the influence at the time of injury. In comparison, 394 patients (39.6 %) had one or more substances above the cut-off limit in blood at the time of admittance to the hospital. Alcohol was the most prevalent substance causing influence at 25.9 %. Among patients with violence-related injuries, almost 75 % were under the influence of alcohol and/or substances. Patients under the influence were younger, and men were more often under the influence than women. More patients were under the influence at nighttime and during weekends than at daytime and on weekdays.



About one third of the injured patients were determined to be under the influence at the time of injury, with alcohol being the most prevalent substance causing influence. Approximately 98 % of the patients with alcohol detected in blood at the time of admittance to the hospital were under the influence of alcohol at the time of injury.
Division of Forensic Sciences, Norwegian Institute of Public Health, PO Box 4404, Nydalen, 0403, Oslo, Norway. Eirin.Bakke@fhi.no.
Eirin
E
Bakke
Division of Forensic Sciences, Norwegian Institute of Public Health, PO Box 4404, Nydalen, 0403, Oslo, Norway.
Stig Tore
ST
Bogstrand
Division of Forensic Sciences, Norwegian Institute of Public Health, PO Box 4404, Nydalen, 0403, Oslo, Norway.
Per Trygve
PT
Normann
Department of Acute Medicine, Oslo University Hospital, 0407, Oslo, Norway.
Øivind
Ø
Ekeberg
Division of Forensic Sciences, Norwegian Institute of Public Health, PO Box 4404, Nydalen, 0403, Oslo, Norway.
Liliana
L
Bachs
D000063:Accidents, Traffic / Q000706:statistics & numerical data; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000437:Alcoholism / Q000097:blood / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital / Q000706:statistics & numerical data*; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway / Q000453:epidemiology; D012737:Sex Factors; D015813:Substance Abuse Detection / Q000379:methods; D019966:Substance-Related Disorders / Q000097:blood / Q000453:epidemiology*; D013997:Time Factors; D014754:Violence / Q000706:statistics & numerical data; D014947:Wounds and Injuries / Q000453:epidemiology*; D055815:Young Adult
Alcohol impairment; Emergency department; Injury; Substance influence