Substance Use in Vulnerable Patients With Orofacial Injury: Prevalence, Correlates, and Unmet Service Needs

Murphy, Debra A.; Shetty, Vivek; Resell, Judith; Zigler, Corwin; Yamashita, Dennis Duke

doi:10.1097/ta.0b013e318164773a

Cited by 19 publications

(20 citation statements)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Similar to previous findings in adult populations,24 substance use was fairly high among this sample of adolescents. The mean screening score for substance use indicated problem-level behaviors for this sample, with more than half of the adolescents scoring above the cut-point.…”

Section: Discussionsupporting

confidence: 90%

Factors Associated With Orofacial Injury and Willingness to Participate in Interventions Among Adolescents Treated in Trauma Centers

Murphy

Shetty

Der‐Martirosian

et al. 2009

Journal of Oral and Maxillofacial Surgery

Self Cite

View full text Add to dashboard Cite

Purpose-Assault is the most common cause of facial injuries in adolescents treated at inner-city trauma centers, yet little is known about the behavioral and environmental antecedents of these injuries or the willingness of such at-risk adolescents to participate in behavioral interventions to minimize re-injury. The purpose of this study was to identify possible risk and protective factors among adolescents with assault-related facial injury, and assess their willingness to participate in prospective observational research and behavioral interventions.Patients and Methods-Interviews were conducted with 67 adolescents (range 14 -20 years) who were treated in trauma centers for facial injuries. Most of these injuries were assault-related (59%), followed by motor vehicle or other accidents (29%), gunshot wounds (9%) and sports injuries (3%). The subjects were predominantly male (86%) and ethnic minorities (91%).Results-The adolescents showed high rates of intentional injuries in the past six months (56%), unhealthy alcohol use, and more than half (55%) had problem levels of substance use. As compared to those with unintentional injuries, adolescents who experienced assault-related injuries were more likely to report using alcohol, tobacco and other substances. Although a significant segment of the sample (55%) had been arrested previously, no differences in arrest rates or types of crimes for which

show abstract

Section: Discussionsupporting

confidence: 90%

Factors Associated With Orofacial Injury and Willingness to Participate in Interventions Among Adolescents Treated in Trauma Centers

Murphy

Shetty

Der‐Martirosian

et al. 2009

Journal of Oral and Maxillofacial Surgery

Self Cite

View full text Add to dashboard Cite

show abstract

“…Moreover, most studies of substance use and injury are restricted to specific anatomic regions (e.g., traumatic brain, spinal, or orofacial), 13–16 specific causes of injury (e.g., motor vehicle incidents or intimate partner or nonpartner violence), 17–20 focus on the age outliers of adolescents or older adults, 21,22 or on alcohol only 23 or drugs only. 24 These studies are limited by small sample sizes, single sites, or restricted numbers of settings and self-report of drug history or, in some cases, limitations of toxicology screening or lack of toxicology screening at the time of injury.…”

mentioning

confidence: 99%

The Association of Injury With Substance Use Disorder Among Women of Reproductive Age: An Opportunity to Address a Major Contributor to Recurrent Preventable Emergency Department Visits?

Bernstein

Belanoff

et al. 2014

Acad Emerg Med

View full text Add to dashboard Cite

Objectives: Substance use disorder (SUD) among women of reproductive age is a complex public health problem affecting a diverse spectrum of women and their families, with potential consequences across generations. The goals of this study were 1) to describe and compare the prevalence of patterns of injury requiring emergency department (ED) visits among SUD-positive and SUD-negative women and 2) among SUD-positive women, to investigate the association of specific categories of injury with type of substance used.Methods: This study was a secondary analysis of a large, multisource health care utilization data set developed to analyze SUD prevalence, and health and substance abuse treatment outcomes, for women of reproductive age in Massachusetts, 2002 through 2008. Sources for this linked data set included diagnostic codes for ED, inpatient, and outpatient stay discharges; SUD facility treatment records; and vital records for women and for their neonates.Results: Injury data (ICD-9-CM E-codes) were available for 127,227 SUD-positive women. Almost twothirds of SUD-positive women had any type of injury, compared to 44.8% of SUD-negative women. The mean (AESD) number of events also differed (2.27 AE 4.1 for SUD-positive women vs. 0.73 AE 1.3 for SUDnegative women, p < 0.0001). For four specific injury types, the proportion injured was almost double for SUD-positive women (49.3% vs 23.4%), and the mean (AESD) number of events was more than double (0.72 AE 0.9 vs. 0.26 AE 0.5, p < 0.0001). The numbers and proportions of motor vehicle incidents and falls were significantly higher in SUD-positive women (22.5% vs. 12.5% and 26.6% vs. 11.0%, respectively), but the greatest differences were in self-inflicted injury (11.5% vs. 0.8%; mean AE SD events = 0.19 AE 0.9 vs. 0.009 AE 0.2, p < 0.0001) and purposefully inflicted injury (11.5% vs 1.9%, mean AE SD events = 0.18 AE 0.1 vs. 0.02 AE 0.2, p < 0.0001). In each of the injury categories that we examined, injury rates among SUD-positive women were lowest for alcohol disorders only and highest for alcohol and drug disorders combined. Among 33,600 women identified as using opioids, 2,132 (6.3%) presented to the ED with overdose. Multiple overdose visits were common (mean AE SD = 3.67 AE 6.70 visits). After adjustment for sociodemographic characteristics, psychiatric history, and complex/chronic illness, SUD remained a significant risk factor for all types of injury, but for the suicide/self-inflicted injury category, psychiatric history was by far the stronger predictor.

show abstract

“…Unlike the swelling, bruising, and radiographic findings that signal a bone fracture, the signs and symptoms of maladaptive stress reactions and ensuing substance use disorders are more subjective and are characterized by a vast range of behaviors. These challenges were evident in our research study (Murphy et al 2008)3 that determined that oral and maxillofacial surgery residents treating facial injury patients did not identify alcohol use in 42% or drug use in over 65% of individuals with substance use behaviors. Current screening practices at unreliable because they rely exclusively on patient self-reports and subjective interviewer assessments of psychopathology.…”

Section: Introductionmentioning

confidence: 74%

Salivary Biosensors for Screening Trauma-Related Psychopathology

Shetty

2010

Oral and Maxillofacial Surgery Clinics of North America

Self Cite

View full text Add to dashboard Cite

Summary Following facial trauma, a distinct subset of patients will go on to develop mental health problems including recalcitrant psychopathology. Early identification of maladaptive stress reactions provides opportunities for initiating preemptive mental health interventions and hinges on the surgeon’s ability to differentiate between transient distress and precursors of recalcitrant psychiatric sequelae. The comprehensive care of injured patients will benefit greatly from objective adjuncts and decision-making tools to complement the clinical evaluation. This chapter addresses meeting the need for practical, standardized and reliable screening strategies through the use of promising developments in the use of stress response biomarkers and biosensing technology. The systematic interrogation of differentially expressed stress response biomarkers in saliva now permit rapid, assessment of the psychopathogical response to the stressor. Quantitative, point-of-use measurements of the traumatic stress response will greatly improve the nosology of post-traumatic stress disorders, and help advance the screening, diagnosis, treatment, and prevention of mental health consequences of violence and trauma.

show abstract

Substance Use in Vulnerable Patients With Orofacial Injury: Prevalence, Correlates, and Unmet Service Needs

Abstract: Background-A large portion of the injuries treated at urban trauma centers are preventable with alcohol and substance use presenting as common antecedent risk factors.

Cited by 19 publications

References 47 publications

Factors Associated With Orofacial Injury and Willingness to Participate in Interventions Among Adolescents Treated in Trauma Centers

Factors Associated With Orofacial Injury and Willingness to Participate in Interventions Among Adolescents Treated in Trauma Centers

The Association of Injury With Substance Use Disorder Among Women of Reproductive Age: An Opportunity to Address a Major Contributor to Recurrent Preventable Emergency Department Visits?

Salivary Biosensors for Screening Trauma-Related Psychopathology

Contact Info

Product

Resources

About