The American College of Surgeons Committee on Trauma recently mandated testing all trauma center patients for alcohol and conducting a Brief Intervention where indicated.  However, in view of research demonstrating that people who abuse alcohol are more likely to abuse multiple substances, we sought to establish the frequency with which patients tested positive for other drugs.

We implemented a policy of testing all trauma patients at the time of admission, regardless of age or severity of injury, for both alcohol and drugs of abuse.  All patients who test positive for either alcohol or drugs of abuse are provided access to a BIRT (Brief Intervention and Referral for Treatment).  Data was analyzed in a standard fashion to determine the incidence of positivity for alcohol, drugs of abuse, and the incidence of dual (or multiple) positivity.

There were 2,888 total admissions to the trauma center between 2003-2008.  Of the 2743 tested for alcohol, 641 (23%) were positive.  Of the 1733 patients tested for drugs of abuse, 532 (30%) were positive, with 255 (9%) positive for both alcohol and drugs.  Testing was performed on 2743 (95%) of patients for alcohol, and 1733 (60%) for drugs of abuse.

The presence of positive toxicology screens in patients admitted to our trauma service is more prevalent than those for alcohol.  Substantial numbers of patients are not being tested for drugs.  Placing increased emphasis on drug testing would provide access to Brief Intervention services for the widest possible array of patients who may be abusing alcohol and other drugs.