Screening for alcohol and substance use in pediatric trauma patients: A retrospective review

PURPOSE: Alcohol and drug use in adolescence is associated with traumatic injuries. This study aimed to assess the rates of screening for substance use in pediatric trauma patients presenting at a single Canadian center. METHODS: A retrospective chart review of pediatric trauma patients (aged 12-17) was performed. Injury specifics, rates of patients screened for alcohol and/or substance use, and screening outcomes were determined. Patients screened were compared to those not screened. Continuous variables were analyzed using independent samples t-tests and categorical using chi-square. Significance was set at p < 0.05. RESULTS: Three hundred twenty-seven patients were included, with 217(66%) being male. The average age was 14.6 years (±1.5). Traffic collisions accounted for 50% of injuries. A blood alcohol test was conducted for significantly more patients (199, 61%) than a urine drug screen (55, 17%; p < 0.001). Of those screened, 27/199(14%) tested positive for alcohol and 29/55(53%) for drugs. Older age and increased injury severity were associated with being screened for drugs (p = 0.000, p = 0.050). Only 39% of patients with positive screening tests were referred on to secondary services such as inpatient psychiatry or social work. CONCLUSION: Screening rates remain low. Institutional guidelines for alcohol and drug screening in trauma patients should be instituted to avoid random screening and underestimations of substance involvement. TYPE OF STUDY: Retrospective Chart Review. LEVEL OF EVIDENCE: III.