Advertisement

European Journal of Trauma and Emergency Surgery

, Volume 40, Issue 6, pp 693–699 | Cite as

Trauma risk perception related to alcohol, cannabis, and cocaine intake

  • S. Cordovilla-Guardia
  • F. Guerrero-López
  • A. Maldonado
  • R. Vilar-López
  • J. M. Salmerón
  • I. Romero
  • S. Pose
  • E. Fernández-Modéjar
Original Article

Abstract

Objective

A high perception of risk may exert a preventive effect against the initiation of risky activities. The aims of the present study were (1) to analyze the risk perception for traumatic incidents according to drug intake (alcohol, cannabis, cocaine, no consumption) by trauma patients admitted to our hospital, and (2) to explore the influence of drugs on trauma recidivism.

Methods

Between 1 November 2011 and 1 April 2012, 404 patients aged between 16 and 70 years were admitted to our hospital for trauma cases. In 363 (89.9 %) of the patients, data were gathered on age, the trauma mechanism, and the consumption of alcohol and other drugs. Out of these 363 patients, 286 (78.8 %) attended a motivational interview and reported their consumption habits and their perception of the risk of trauma after alcohol and/or illegal drug consumption, as well as the antecedents of previous traumatisms.

Results

Alcohol and/or illegal drugs were detected in 37 % of the sample, with alcohol being the most frequently detected, followed by cannabis, cocaine, and other drugs. Among the trauma patients with no consumption, a high perception of trauma risk was associated with alcohol intake by 95.9 %, with cannabis consumption by 68.4 %, and with cocaine consumption by 53.4 %, whereas these percentages were significantly lower for patients testing positive for substances (79.3, 21.1, and 8.3 % respectively). Among the patients experiencing their first trauma, the mean age was almost 15 years younger in those who were positive for these substances than in those who were negative (p < 0.001). Finally, a history of previous trauma was reported by a majority (64 %) of the trauma patients testing positive for alcohol and/or drugs, but by a minority (36 %) of those testing negative (p < 0.001).

Conclusions

The low perception of risk associated with alcohol, cannabis, or cocaine consumption by trauma patients under the influence of these substances on admission may be a predisposing factor for recidivism. Recommendations for both primary and secondary prevention are presented.

Keywords

Alcohol Drugs Motivational intervention Trauma recidivism Risk perception 

Notes

Conflict of interest

This research was funded by a Spanish Ministry of Science and Innovation (MICINN) grant to A. Maldonado (Ref PSI2009-12217); support from the RETICS Program (Red de Trastornos Adictivos), Instituto de Salud Carlos III, Spanish Ministry of Health, to Raquel Vilar López; and a National Department of Traffic (DGT) (Ref. 0100DGT22389) grant to Sergio Cordovilla Guardia.

Francisco Guerrero López, Jose Miguel Salmerón, Inmaculada Romero, Susana Pose, and Enrique Fernandez Mondejar declare that they have no conflicts of interest.

Ethical standards

The study was approved by the hospital research ethics committee, which waived the need for informed consent for this observational and anonymous investigation. This manuscript has been conducted in compliance with internationally accepted ethical standards.

References

  1. 1.
    Lundberg GD. Ethyl alcohol: ancient plague and modern poison. JAMA. 1984;252:1911–2.PubMedCrossRefGoogle Scholar
  2. 2.
    Rivara FP, Jurkovich GJ, Gurney JF. The magnitude of acute and chronic alcohol abuse in trauma patients. Arch Surg. 1993;128:907–13.PubMedCrossRefGoogle Scholar
  3. 3.
    Marquet P, Delpla P-A, Kerguelen S, et al. Prevalence of drugs of abuse in urine of drivers involved in road accidents in France: a collaborative study. J Forensic Sci. 1998;43:806–11.PubMedGoogle Scholar
  4. 4.
    Movig KL, Mathijssen MP, Nagel PH, et al. Psychoactive substance use and the risk of motor vehicle accidents. Accident Anal Prev. 2004;36:631–6.CrossRefGoogle Scholar
  5. 5.
    Ramaekers J, Berghaus G, van Laar M, et al. Performance impairment and risk of motor vehicle crashes after cannabis use. In: Proceedings of the International Scientific Conference on Cannabis. Rodin Foundation, Ministry of Public Health of Belgium 2002. p. 69–87.Google Scholar
  6. 6.
    Kuypers KP, Legrand SA, Ramaekers JG, et al. A case-control study estimating accident risk for alcohol, medicines and illegal drugs. PLoS One. 2012;7:e43496.PubMedCentralPubMedCrossRefGoogle Scholar
  7. 7.
    Hels T, Lyckegaard A, Simonsen KW, et al. Risk of severe driver injury by driving with psychoactive substances. Accid Anal Prev. 2013;59C:346–56.CrossRefGoogle Scholar
  8. 8.
    DRUID Project: driving under the Influence of Drugs, Alcohol and Medicines. Summary of Main DRUID Results. 2013. http://www.druidproject.eu/cln_031/nn_1109574/Druid/EN/Dissemination/downloads__and__links/2012__Washington__Brochure,templateId=raw,property=publicationFile.pdf/2012_Washington_Brochure.pdf. Accessed 20 Aug 2013.
  9. 9.
    DRUID Project: driving under the influence of drugs, alcohol and medicines. Prevalence of alcohol and other psychoactive substances in drivers in general traffic Part I: general results. 2013. http://www.druid-project.eu/cln_031/nn_107548/Druid/EN/deliverales-list/downloads/Deliverable__2__2__3__Part1,templateId=raw,property=publicationFile.pdf/Deliverable_2_2_3_Part1.pdf. Accessed 20 Aug 2013.
  10. 10.
    Diaz R, Herrera L, Lara R, et al. Alcohol and drugs of abuse in traumatised patients. Med Intensiva. 2008;32:222–6.CrossRefGoogle Scholar
  11. 11.
    Proyecto DRUID: Presencia de alcohol, drogas y medicamentos en conductores españoles. 2013. http://www.dgt.es/was6/portal/contenidos/documentos/seguridad_vial/estudios_informes/informe_final_druid_prevalencia_espana.pdf. Accessed 20 Aug 2013.
  12. 12.
    Ministerio de Sanidad, Política Social e Igualdad. Lesiones medulares traumáticas y traumatismos craneoencefálicos en España, 2000–2008. Secretaría General, Centro de Publicaciones: Madrid.Google Scholar
  13. 13.
    Cordovilla Guardia S, Rodríguez-Bolaños S, Guerrero López F, et al. Alcohol and/or drug abuse favors trauma recurrence and reduces the trauma-free period. Med Intensiva. 2013;37:6–11.PubMedCrossRefGoogle Scholar
  14. 14.
    Kaufmann CR, Branas CC, Brawley ML. A population-based study of trauma recidivism. J Trauma. 1998;45:325–31.PubMedCrossRefGoogle Scholar
  15. 15.
    Lund IO, Rundmo T. Cross-cultural comparisons of traffic safety, risk perception, attitudes and behaviour. Saf Sci. 2009;47:547–53.CrossRefGoogle Scholar
  16. 16.
    Matthews A, Bruno R, Johnston J, et al. Factors associated with driving under the influence of alcohol and drugs among an Australian sample of regular ecstasy users. Drug Alcohol Depend. 2009;100:24–31.PubMedCrossRefGoogle Scholar
  17. 17.
    Albery IP, Strang J, Gossop M, et al. Illicit drugs and driving: prevalence, beliefs and accident involvement among a cohort of current out of treatment drug users. Drug Alcohol Depend. 2000;58:197–204.PubMedCrossRefGoogle Scholar
  18. 18.
    Kelly E, Darke S, Ross J. A review of drug use and driving: epidemiology, impairment, risk factors and risk perceptions. Drug Alcohol Rev. 2004;23:319–44.PubMedCrossRefGoogle Scholar
  19. 19.
    Dunn C, Ostafin B. Brief interventions for hospitalized trauma patients. J Trauma. 2005;59:S88–93.PubMedCrossRefGoogle Scholar
  20. 20.
    Gentilello LM. Alcohol and injury: American College of surgeons committee on trauma requirements for trauma center intervention. J Trauma. 2007;62:S44–5.PubMedCrossRefGoogle Scholar
  21. 21.
    Gentilello LM, Rivara FP, Donovan DM, et al. Alcohol interventions in a trauma center as a means of reducing the risk of injury recurrence. Ann Surg. 1999;230:473–80.PubMedCentralPubMedCrossRefGoogle Scholar
  22. 22.
    Kelleher DC, Renaud EJ, Ehrlich PF, et al. Guidelines for alcohol screening in adolescent trauma patients: a report from the Pediatric Trauma Society Guidelines Committee. J Trauma. 2013;74:671–82.CrossRefGoogle Scholar
  23. 23.
    Babor TF, Grant M. From clinical research to secondary prevention: international collaboration in the development of the alcohol use disorders identification test (AUDIT). Alcohol Haelth Res World. 1989;13:371–4.Google Scholar
  24. 24.
    McCoy AM, Como JJ, Greene G, et al. A novel prospective approach to evaluate trauma recidivism: the concept of the past trauma history. J Trauma Acute Care Surg. 2013;75:116–21.PubMedCrossRefGoogle Scholar
  25. 25.
    Copes WS, Champion HR, Sacco WJ, et al. The injury severity score revisited. J Trauma. 1988;28:69–77.PubMedCrossRefGoogle Scholar
  26. 26.
    Mura P, Kintz P, Ludes B, et al. Comparison of the prevalence of alcohol, cannabis and other drugs between 900 injured drivers and 900 control subjects: results of a French collaborative study. Forensic Sci Int. 2003;133:79–85.PubMedCrossRefGoogle Scholar
  27. 27.
    Robbe H. Marijuana’s impairing effects on driving are moderate when taken alone but severe when combined with alcohol. Hum Psychopharm. 1998;13:S70–8.CrossRefGoogle Scholar
  28. 28.
    MacDonald S, Anglin-Bodrug K, Mann RE, et al. Injury risk associated with cannabis and cocaine use. Drug Alcohol Depend. 2003;72:99–115.PubMedCrossRefGoogle Scholar
  29. 29.
    Laumon B, Gadegbeku B, Martin J-L, et al. Cannabis intoxication and fatal road crashes in France: population based case-control study. BMJ. 2005;331:1371–7.PubMedCentralPubMedCrossRefGoogle Scholar
  30. 30.
    Asbridge M, Poulin C, Donato A. Driving under the influence of cannabis and motor vehicle collision risk: evidence from adolescents in Atlantic Canada. Accid Anal Prev. 2005;37:1025–34.PubMedCrossRefGoogle Scholar
  31. 31.
    Asbridge M, Hayden JA, Cartwright JL. Acute cannabis consumption and motor vehicle collision risk: systematic review of observational studies and meta-analysis. BMJ. 2012;344:e536.PubMedCentralPubMedCrossRefGoogle Scholar
  32. 32.
    Norton R, Kobusingye O. Injuries. N Engl J Med. 2013;368:1723–30.PubMedCrossRefGoogle Scholar
  33. 33.
    Miñambres E. Alcohol, drugs and traumatisms: can we break the vicious circle? Med Intensiva. 2013;37:1–2.PubMedCrossRefGoogle Scholar
  34. 34.
    Madras BK, Compton WM, Avula D, et al. Screening, brief interventions, referral to treatment (SBIRT) for illicit drug and alcohol use at multiple healthcare sites: comparison at intake and 6 months later. Drug Alcohol Depend. 2009;99:280–95.PubMedCentralPubMedCrossRefGoogle Scholar
  35. 35.
    Real Decreto 1428/2003 de 21 de noviembre, por el que se aprueba el reglamento general de circulación para la aplicación y desarrollo del texto articulado de la ley sobre tráfico, circulación de vehículos a motor y seguridad vial, aprobado por Real Decreto Legislativo 339/1990, de 2 de marzo.Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • S. Cordovilla-Guardia
    • 1
  • F. Guerrero-López
    • 1
  • A. Maldonado
    • 2
    • 3
  • R. Vilar-López
    • 3
    • 4
  • J. M. Salmerón
    • 1
  • I. Romero
    • 1
  • S. Pose
    • 4
  • E. Fernández-Modéjar
    • 1
  1. 1.Intensive Care Unit, Critical Care and Emergency DepartmentVirgen de las Nieves University HospitalGranadaSpain
  2. 2.Experimental Psychology DepartmentUniversity of GranadaGranadaSpain
  3. 3.Mind, Brain, and Behavior Research CentreGranadaSpain
  4. 4.Department of Clinical PsychologyUniversity of GranadaGranadaSpain

Personalised recommendations