PM1053: Missed Opportunities: Substance Use in Adolescent Trauma Patients

Background: The adolescent population is known to have increased risk-taking behaviors including substance use. To evaluate substance use in this population, toxicology testing is universally ordered in all trauma patients presenting at our center. We hypothesized a high rate of substance use among traumatically injured adolescent trauma patients.

Methods: A single-institution retrospective review of trauma patients aged 16-20 years old from May 2018-July 2021 was completed. A total of 1002 visits met inclusion criteria. Variables including demographics, injury characteristics, procedural data, urine and drug toxicology results, social work intervention and discharge status were analyzed via Chi-square and Fisher’s exact tests.

Results: The majority of patients were male (72.6%), black (81.8%), and had penetrating injuries (57.5%). 86.2% were screened for alcohol and/or substances; of those, 6.2% were positive for alcohol and 12.4% were positive for illicit substances. Those that tested positive for alcohol were more likely to experience blunt trauma 61.1% vs 42.6% (p=0.03). Patients that self-reported alcohol use had a higher re-injury rate, 72.3% vs 48.1% (p=0.004). Substance use had no effect on follow-up or hospital-based social work interventions [48.7% vs 45.9% (p=0.96) and 28.6% vs 25.7% (p=0.15), respectively]. Any social work intervention was positively correlated with clinic follow-up 31.9% vs 20.2% (p < 0.001) (Figure 1).

Conclusion: In this series, nearly 1 out of 5 adolescent trauma patients screened positive for either alcohol or illicit substances. 13.8% were not screened and nearly three-quarters who were positive did not receive any social work intervention. There is a missed opportunity to provide these patients with substance use education and counseling. Further studies are needed to determine if universal screening and diligent social work interventions help to correct adolescent alcohol and substance use and prevent trauma re-injury.