Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Oct;62(10):661-668.
doi: 10.1080/15563650.2024.2400186. Epub 2024 Sep 28.

Detection of ethanol, cannabinoids, benzodiazepines, and opioids in older adults evaluated for serious injuries from falls

Kavita M Babu  1 , Yara K Haddad  2 , Shakiera T Causey  3 , Carmen C Vargas-Torres  4 , Patricia Mae Martinez  4 , Elizabeth M Goldberg  5 , Jon D Dorfman  1 , Julia A Bleser  3 , Brittany P Chapman  1 , Jeffrey T Lai  1 , Riyadh Saif  1 , Romanda Elhoussan  1 , Lindsey A Graham  6 , Alex J Krotulski  7 , Sara E Walton  7 , F Dennis Thomas  6 , Barry K Logan  7 , Roland C Merchant  4
Affiliations

Detection of ethanol, cannabinoids, benzodiazepines, and opioids in older adults evaluated for serious injuries from falls

Kavita M Babu et al. Clin Toxicol (Phila). 2024 Oct.

Erratum in

  • Corrections.
    [No authors listed] [No authors listed] Clin Toxicol (Phila). 2024 Nov;62(11):786. doi: 10.1080/15563650.2024.2415238. Epub 2024 Oct 10. Clin Toxicol (Phila). 2024. PMID: 39388201 No abstract available.

Abstract

Background: In 2020, there were 36.7 million reported falls among older adults (65+) in the United States. Ethanol and other sedating substances may increase fall risk among older adults due to their effect on cognitive and physical function. We estimate the prevalence of these substances in blood specimens of older adults presenting with a fall injury at selected trauma centers.

Methods: The initial study collected blood specimens from May 2020 through July 2021 from adults undergoing a trauma team evaluation at selected United States Level 1 trauma centers. We limited our study to older adults evaluated after a fall (n = 1,365) and selected a random sample (n = 300) based on age, sex, and trauma-center quotas. Medical health records and blood specimens obtained at trauma center presentation were analyzed. We estimated the prevalence of ethanol, benzodiazepines, cannabinoids, and opioids in the blood specimens. Two-sample tests of binomial proportions and Chi-square two-tailed tests were used to compare prevalence estimates of substances by demographic characteristics.

Results: At least one substance was detected among 31.3% of samples analyzed. Prevalences of specific substances detected were 9.3% (95% CI: 6.0-12.6%) for benzodiazepines, 4.3% (95% CI: 2.0-6.7%) for cannabinoids, 8.0% (95% CI: 5.2-11.7%) for ethanol, and 15.0% (95% CI: 10.9-19.1%) for opioids. There were 18 deaths (6%; 95% CI: 3.6-9.3%). One-third of decedents had at least one substance detected in their blood.

Discussion: Opioids were the most frequently detected substance, followed by benzodiazepines, ethanol, and cannabinoids. Substance use prevalence was not uniform across demographics, with differences observed by sex and age.

Conclusions: This study provides insight into the frequency of the presence of substances that may contribute to fall risk and serious injury among older adults. Screening older adults for substances that impair cognitive and physical function can enhance clinical fall prevention efforts.

Keywords: Emergency medicine; ethanol; falls; older adults; substances.

PubMed Disclaimer

Conflict of interest statement

Disclosure statement

No potential conflict of interest was reported by the authors.

Figures

Figure 1.
Figure 1.
Enrollment schema.
See this image and copyright information in PMC

References

    1. Salari N, Darvishi N, Ahmadipanah M, et al. Global prevalence of falls in the older adults: a comprehensive systematic review and meta-analysis. J Orthop Surg Res. 2022;17(1):334. doi: 10.1186/s13018-022-03222-1. - DOI - PMC - PubMed
    1. James SL, Lucchesi LR, Bisignano C, et al. The global burden of falls: global, regional and national estimates of morbidity and mortality from the Global Burden of Disease Study 2017. Inj Prev. 2020;26(Supp. 1):i3–i11. doi: 10.1136/injuryprev-2019-043286. - DOI - PMC - PubMed
    1. Kakara R, Bergen G, Burns E, et al. Nonfatal and fatal falls among adults aged >/=65 years – United States, 2020–2021. MMWR Morb Mortal Wkly Rep. 2023;72(35):938–943. doi: 10.15585/mmwr.mm7235a1. - DOI - PubMed
    1. Gill TM, Murphy TE, Gahbauer EA, et al. Association of injurious falls with disability outcomes and nursing home admissions in community-living older persons. Am J Epidemiol. 2013;178(3):418–425. doi: 10.1093/aje/kws554. - DOI - PMC - PubMed
    1. Duque G Age-related physical and physiologic changes and comorbidities in older people: association with fall. In: Huang A, Mallett L, editors. Medication-related falls in older people: causative factors and management strategies. Switzerland: Springer International Publishing; 2016.