Trauma patients who tested positive for any substance, including cannabis, had significantly higher rates of previous trauma | Research

The takeaway

Among over 1,100 trauma patients, those testing positive for alcohol, cannabis, or other drugs had 3.2 times the odds of having multiple prior traumas, regardless of age, gender, or psychiatric history.

Read this if you want to understand the cycle between substance use and repeated traumatic injuries.

Substance-positive trauma patients: 3.2x odds of multiple previous traumas

What the researchers found

Of 1,156 trauma patients (ages 16-70) hospitalized between 2011 and 2015, at least one substance was detected in 45.1%. Cannabis alone was found in 5.4% of patients. The consumption of any substance was associated with increased trauma recidivism (having a documented history of past trauma).

The adjusted odds ratio for multiple recidivism (more than one past trauma) was 3.17, and this association held regardless of age, gender, or the presence of previous psychiatric disorders. All substance groups (alcohol alone, cannabis alone, psychotropic medications, stimulants, and combinations) showed increased recidivism.

Why it matters

The finding that substance-positive trauma patients are significantly more likely to have prior traumas suggests a recurring cycle of substance use and injury. Screening for substance use in trauma settings could identify patients at high risk for future injuries and target them for intervention.

The numbers in context

Substances detected in 45.1% of patients. Cannabis alone: 5.4%. Alcohol alone: 13.7%. Psychotropic medications: 12.5%. Multiple substances: 12.2%. Adjusted OR for multiple recidivism: 3.17 (95% CI 2.29-4.39).

How the study worked

Cross-sectional analysis of 1,156 trauma patients admitted to a Spanish trauma hospital from November 2011 to March 2015. Substance presence was determined by laboratory testing (immunoassay for alcohol and 10 drug classes). Past trauma history was retrieved from the health information system covering records since 1999. Multinomial logistic regression estimated associations.

What this study cannot tell us

Cross-sectional design cannot determine whether substance use causes trauma or whether trauma-prone individuals use more substances. Cannabis detection can reflect use days before the trauma event. Substance testing captures current intoxication, not chronic use patterns. Single-center study in Spain.

How to read the evidence

Cross-sectional analysis of trauma patients with laboratory-confirmed substance detection and medical record verification of past traumas. Well-designed but limited by single center and cross-sectional nature.

When this study was published

Published in 2017. Trauma-based substance use screening and intervention programs continue to develop.

The bigger picture

Trauma recidivism is a major healthcare burden. If substance use is both a cause of individual trauma events and a marker for repeated trauma, then trauma admissions represent a "teachable moment" for substance use intervention. Brief interventions in trauma centers could potentially break the cycle.

Questions still open

Would brief substance use interventions in trauma centers reduce re-injury rates? Is cannabis-related trauma recidivism dose-dependent? Do different substances predict different types of trauma recurrence?

Common questions

Does cannabis use make you more likely to get hurt?

This study found that trauma patients who tested positive for cannabis (or other substances) were more likely to have prior trauma history. However, it cannot determine whether cannabis caused the injuries or whether other factors (risk-taking behavior, lifestyle) explain both the substance use and the injuries.

Why screen for drugs in trauma patients?

The high rate of substance detection (45%) and strong association with trauma recidivism suggests that substance use is a modifiable risk factor for repeated injury. Identifying substance-involved trauma patients creates opportunities for intervention that could prevent future injuries.

Read the original research

Alcohol or Drug Use and Trauma Recidivism.

Nursing research, 66(5), 399-404

View on PubMed ↗Publisher’s paper ↗

Citation

Cordovilla-Guardia, Sergio; Vilar-López, Raquel; Lardelli-Claret, Pablo; Guerrero-López, Francisco; Fernández-Mondéjar, Enrique. (2017). Alcohol or Drug Use and Trauma Recidivism.. Nursing research, 66(5), 399-404. https://doi.org/10.1097/NNR.0000000000000231