The Effect of Substance Abuse Programs on Positive Drug Screening Tests in Trauma Patients

Am Surg. 2020 Dec;86(12):1717-1720. doi: 10.1177/0003134820943637. Epub 2020 Aug 31.

Abstract

Background: According to the National Institute on Drug Abuse, West Virginia has the highest age-adjusted rate of drug overdose deaths involving opioids. To combat this crisis, comprehensive drug counseling support services were established within the Cabell Huntington Hospital (CHH) system in October 2018 in Huntington, WV, USA. The purpose of this study was to investigate whether these services significantly reduced the number of trauma patients with a positive urine drug screen (UDS) seen at CHH.

Methods: The trauma registry at CHH was used to obtain data on trauma patients with positive UDS from January 2017 to October 2019, which was divided into groups before and after October 2018. Exclusion criteria were any patients who were prescribed the drug. The percentages of the total number of positive drug screens within each group were calculated, and a t-test analysis was performed to determine the P values.

Results: 345 trauma patients with positive UDS were selected. Results showed that there was an overall decrease in the rate of nonprescribed use after October 2018 of benzodiazepines (18.1%-11.5%), cocaine (19.5%-15.3%), opioids (19.1%-12.3%), and oxycodone (10.2%-4.6%). However, none of these changes were statistically significant. There was an increase in the rate of nonprescribed use of amphetamine (20.0%-23.8%) and methamphetamine (14.4%-33.8%).

Discussion: Our hypothesis is that the support systems are relatively new, and may need more time to identify and intervene on patients before a statistically significant effect on drug abuse rates in our region can be seen.

Keywords: drug abuse; socioeconomic; trauma.

MeSH terms

  • Adult
  • Aged
  • Drug Overdose
  • Emergency Service, Hospital
  • Female
  • Humans
  • Male
  • Middle Aged
  • Registries
  • Substance Abuse Detection / methods*
  • Substance-Related Disorders / epidemiology*
  • Trauma Severity Indices
  • West Virginia / epidemiology
  • Wounds and Injuries / epidemiology*