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Sat Aug 19 01:05:39 BST 2006

Drug and alcohol abuse and trauma are very closely linked. If folks in Detroit would drink responsible and stop using crack cocaine, from my estimate, the trauma case list would be reduced to little old ladies with fractured hips (and occasionally these girls have had a nip of brandy prior to their fall).

I am not opposed to mandatory screening in trauma patients (Level I, II, or III), but the question remains: What to do with the data, other than use it for medical care.

In terms of intervention, we don't have the resources. I suspect that the only coucelling they get is from me, telling them that they might want to rethink their vises and behavior - as the surgical team takes them off to the OR. They are seen by Social Work postop (who are over-worked, understaffed, and underpaid), but the best that the law allows (unless they are being charged with a crime) in terms of intervention is referral to outpatient services - which will usually only see them if they have insurance.

I recall a study done in Baltimore many years ago. They screened trauma victims for EtOH and drugs of abuse and found (as I recall): a majority of victims had EtOH and another substance on board, followed by EtOH only, followed by nothing, followed by marijuanna. In other words, in terms of being a trauma victim, you were more likely to be a victim if you were straight than if you smoked pot. Obviously, we don't encourage our patients to toke down as a way of avoiding becoming a trauma victim. But, this illistrated the problems interpreting data obtained by dredging patient records.

DB

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For your convenience, find the Trauma List Archive Below

Alcohol Screening (revisited)