INTRODUCTION: The practice of assessing only trauma patients with elevated blood alcohol concentrations (BACs) or positive drug screens for psychoactive substance use disorders (PSUDs) was evaluated. METHODS: Twenty-four BAC-negative (BAC-) (BAC, 0) and 21 BAC-positive (BAC+) (BAC, greater than or equal to 22 mmol/L or 100 mg/dL; mean, 41 mmol/L; range, 24.3 to 79 mmol/L) adult trauma patients were evaluated for alcoholism and other PSUDs using the Structured Clinical Interview (SCI) from the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R). Approximately half were vehicular crash victims and 78% were men. RESULTS: A total of 64 PSUDs were diagnosed in 31 (68.9%) of the 45 patients; all but one was for dependence (vs abuse). Of the BAC+ patients, 14 (66.7%) met DSM-III-R criteria for alcohol dependence, 11 (78.6%) of whom also had other PSUDs not related to alcohol. Two other BAC+ patients had nonalcohol PSUDs. Of the BAC- patients, 11 (45.8%) had alcohol dependence, six (54.5%) of whom also had nonalcohol PSUDs. Another four BAC- patients had nonalcohol PSUDs. Overall, 76.2% of the BAC+ patients and 62.5% of the BAC- patients had a diagnosis of psychoactive substance dependence. CONCLUSION: All patients admitted to trauma centers should be assessed for alcoholism and other PSUDs.
INTRODUCTION: The practice of assessing only traumapatients with elevated blood alcohol concentrations (BACs) or positive drug screens for psychoactive substance use disorders (PSUDs) was evaluated. METHODS: Twenty-four BAC-negative (BAC-) (BAC, 0) and 21 BAC-positive (BAC+) (BAC, greater than or equal to 22 mmol/L or 100 mg/dL; mean, 41 mmol/L; range, 24.3 to 79 mmol/L) adult traumapatients were evaluated for alcoholism and other PSUDs using the Structured Clinical Interview (SCI) from the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition (DSM-III-R). Approximately half were vehicular crash victims and 78% were men. RESULTS: A total of 64 PSUDs were diagnosed in 31 (68.9%) of the 45 patients; all but one was for dependence (vs abuse). Of the BAC+ patients, 14 (66.7%) met DSM-III-R criteria for alcohol dependence, 11 (78.6%) of whom also had other PSUDs not related to alcohol. Two other BAC+ patients had nonalcohol PSUDs. Of the BAC- patients, 11 (45.8%) had alcohol dependence, six (54.5%) of whom also had nonalcohol PSUDs. Another four BAC- patients had nonalcohol PSUDs. Overall, 76.2% of the BAC+ patients and 62.5% of the BAC- patients had a diagnosis of psychoactive substance dependence. CONCLUSION: All patients admitted to trauma centers should be assessed for alcoholism and other PSUDs.
Authors: Douglas Zatzick; Dennis Donovan; Christopher Dunn; Joan Russo; Jin Wang; Gregory Jurkovich; Frederick Rivara; Lauren Whiteside; Richard Ries; Larry Gentilello Journal: J Subst Abuse Treat Date: 2012-09-19
Authors: Lauren M Sakai; Thomas J Esposito; Hieu H Ton-That; Ellen C Omi; Elizabeth J Kovacs; Carol R Schermer Journal: Alcohol Treat Q Date: 2012-10-12
Authors: Francine Terrell; Douglas F Zatzick; Gregory J Jurkovich; Frederick P Rivara; Dennis M Donovan; Christopher W Dunn; Carol Schermer; Jay Wayne Meredith; Larry M Gentilello Journal: J Am Coll Surg Date: 2008-07-14 Impact factor: 6.113