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Sat Aug 19 13:04:52 BST 2006

I am confused by the last paragraph - the fact is (NHTSA data) that the
majority of those involved in a MVC have alcohol or drugs on board, the
majority of pedestrian fatalities are drunk pedestrians, and other data
has shown that many/most violent crimes involve alcohol/drug abuse.

You are correct about the availability of getting social services to
people with substance abuse, but regardless of how many times you are
successfull, the recidivism rate for those that you are successful
counceling is 50% less than those not councelled.  

SO............

Take care,
Ron

>>> <bensonblues at comcast.net> 08/18/06 8:05 PM >>>
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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