Cannabis Was the Most Commonly Detected Substance in Assault-Injured Black Men in Baltimore

Cannabis was the most frequently detected substance (42.5%), followed by alcohol (24.4%), opioids (22.3%), and cocaine (3.6%). Men who screened positive for cannabis had 32% lower odds of stabbing versus shooting and 50% lower odds of blunt force assault versus shooting. In contrast, alcohol was associated with stabbing and blunt force rather than firearm assault.

Retrospective analysis of 1,922 Black men aged 18-34 admitted to a Baltimore trauma center with assault-related injuries and toxicology screens between 2013 and 2017. Multinomial logistic regression examined associations between substance detection and injury type (blunt force, stabbing, firearm).

This study provides real-world data on substance use patterns among a population disproportionately affected by violence. The differential associations between specific substances and injury types suggest that contextual and environmental factors linked to different substances may influence the type of violence encountered.

The finding that cannabis and alcohol are associated with different types of assault injuries reflects the complex interplay between substance use, social environments, and exposure to violence. The high rate of cannabis detection does not necessarily imply that cannabis contributed to the violence itself.

Toxicology screens detect recent use but cannot determine whether the person was intoxicated at the time of assault. The study cannot establish whether substance use caused or contributed to the assault. Trauma center data may over-represent more severe injuries. Baltimore-specific findings may not generalize to other cities.