The Prevalence of Positive Drug and Alcohol Screens in Elderly Trauma Patients  . 

Ekeh AP, Parikh PP, Walusimbi M, Woods RJ, Hawk A, McCarthy MC. The prevalence of positive drug and alcohol screens in elderly trauma patients. Subst Abus. 2014;35(1):51-5. doi: 10.1080/08897077.2013.797539. PMID: 24588293.

I chose to present this article on the prevalence of alcohol/drug use in elderly trauma patients in the ED in conjunction with my patient case of a 73-year-old male who fell at home and had a positive alcohol screen in the ED, where he then went into alcohol withdrawal requiring admission.

Alcohol and drug use is known to be prevalent in trauma patients, however the incidence of it causing trauma in elderly patients has little current data. The objective of this article was to identify the number of positive drug/alcohol screens in patients >65 admitted to a level I trauma center. 

They used a American College Surgeons level I trauma center, and identified patients >65 who were admitted over a 60-month period. They collected demographic data, blood alcohol levels, and urine drug screen. In the 5 years 4139 patients were admitted, but only 1302 (31.5%) had alcohol/drug screening performed. Of those tested 11.1% had a positive blood alcohol level and 48.3% had a positive urine drug screen. The results show that alcohol and drug use are an issue in the elderly, and that patients should be screened on admission to identify those who require intervention for drug/alcohol abuse. 

The study had some limitations. The data collected was from a single level I trauma center, and may not represent trauma centers all over the country. Additionally they were not able to identify which drug was positive on all the urine drug screens (opioids vs benzodiazepines etc.) or if the drugs positive was actually a medically prescribed medication. This may lead to an overestimation on drug abuse.  

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