Substance use in vulnerable patients with orofacial injury: prevalence, correlates, and unmet service needs

Abstract

Background: A large portion of the injuries treated at urban trauma centers are preventable with alcohol and substance use presenting as common antecedent risk factors.

Methods: Alcohol and drug use characteristics of vulnerable adults treated for intentional orofacial injury at a regional trauma center were investigated. Patients (N = 154) presenting with intentional facial injury were recruited. Patients were considered eligible for recruitment if they were adults, recently used alcohol or drugs, and had a fracture within the 30 days preceding recruitment that involved the jaw, orbit, nose, or cheekbone as determined by clinical history, examination, and radiographic findings and that injury was due to interpersonal violence.

Results: This patient cohort evidenced significant levels of alcohol use, with 58% of our patient cohort meeting the criteria for problem drinking. Although lower than alcohol use rates, the reported use of illicit drugs was substantial. Almost half of the sample reported other substance use in the previous month, with 24% meeting the criteria for problem drug use.

Conclusions: Despite the very high percentage of individuals needing alcohol or drug treatment, only a small proportion of the patient sample reported having seen a professional for alcohol or drug treatment. Integrating substance use services into trauma care is discussed.

Figure 1

Histogram of injury severity