One investigation found that trauma survivors with psychoactive drug use were more likely to be younger, have a lower income and education level, and have a history of tobacco and substance use. Studies have linked specific trauma center patient clinical and demographic characteristics with higher risk of alcohol and drug use comorbidity. 15 This investigation also documented an association between psychoactive drug use at admission and worsened physical and mental health outcomes after admission. 15–17 A recent investigation conducted at three trauma center sites found that 30% of trauma patients screened positive for one or more psychoactive drugs, including methamphetamine, opioids, phencyclidine, methylenedioxymethamphetamine (ecstasy), cannabinoids, tricyclic antidepressants, benzodiazepines and barbiturates. 14 Subsequent investigations have also documented high frequencies of opioid, stimulant, and cannabis use comorbidity among hospitalized injury survivors. In an initial single-site level I trauma center study, over half of consecutively sampled injured trauma survivors displayed a lifetime alcohol or drug use disorder. Similarly, extensive literature documents high frequencies of alcohol and drug use, including opioids, amphetamines, other stimulants (eg, cocaine) and marijuana, in trauma center patients. 2–6 Elevated early PTSD symptom levels after an injury have been shown to be associated with the later development of a clinical diagnosis of PTSD in the months after an injury hospitalization 7 8 After injury, PTSD symptoms are associated with a broad profile of functional impairments and diminished quality of life.
1 Multiple investigations now document a high prevalence of symptoms consistent with post-traumatic stress disorder (PTSD) at rates of 20% or greater among hospitalized US injury survivors. In 2019, approximately 2.8 million Americans were so severely injured that they required inpatient hospital admission.