Use of Cannabis and Alcohol by patients diagnosed with trauma in a Health Emergency Unit
Keywords:Cannabis; Injuries; Accidents; Violence.
There are few data on the association of physical trauma and consumption of psychoactive substances. Objective: To investigate the use of marijuana and alcohol by trauma victims becomes important to subsidize prevention actions. Methods: 299 willingly given samples from individuals hospitalized in the years 2015-2017 due to trauma associated to the use of drugs of abuse were analyzed; the individuals were considered user of drugs of abuse either due to medical diagnosis or to self-reporting. Biological samples from the patients were first trialed for Cannabis; confirmation of cannabis use was performed via gas chromatography-mass spectrometry. Alcoholaemia was also investigated. Results: Males made up the majority of the assessed subjects (91.4%), their average age being 40 years. The major causes for trauma included traffic accidents (46.82%) followed by violence/aggression (26.77%). Toxicological trialing for cannabis resulted in 14.72% positive samples and alcoholaemia varied between 9.38 to 17.85%. Conclusion: The abusive use of Cannabis is a risk factor for accidents and violence leading to traumatic injuries. The age range between the second and fourth decade of life and the automotive steering were relevant predictors for the use of Cannabis. Epidemiological studies provide important information to support preventive measures, considering the scarcity of studies on this theme.
Abreu, A. M. M., Parreira, P. M. S. D., Souza, M. H. do N., Barroso, T. M. M. D. de A., Abreu, A. M. M., Parreira, P. M. S. D., Souza, M. H. do N., & Barroso, T. M. M. D. de A. (2016). Profile of Consumption of Psychoactive Substances and Its Relationship To Sociodemographic Characteristics: a Contribution To a Brief Intervention in Primary Health Care, Rio De Janeiro, Brazil. Texto & Contexto - Enfermagem, 25(4), 1–9. https://doi.org/10.1590/0104-07072016001450015
Andreuccetti, G., Cherpitel, C. J., Carvalho, H. B., Leyton, V., Miziara, I. D., Munoz, D. R., Reingold, A. L., & Lemos, N. P. (2018). Alcohol in combination with illicit drugs among fatal injuries in Sao Paulo, Brazil: an epidemiological study on the association between acute substance use and injury. Injury. https://doi.org/10.1016/j.injury.2018.09.035
Bakke, E., Bogstrand, S. T., Normann, P. T., Ekeberg, Ø., & Bachs, L. (2016). Influence of alcohol and other substances of abuse at the time of injury among patients in a Norwegian emergency department. BMC Emergency Medicine, 16(1), 20. https://doi.org/10.1186/s12873-016-0085-2
Banta-Green, C. (2016). Cannabis Use among Drivers Suspected of Driving Under the Influence or Involved in Collisions: Analysis of Washington State Patrol Data. Foundation for Traffic Safety. https://aaafoundation.org/cannabis-use-among-drivers-suspected-driving-influence-involved-collisions-analysis-washington-state-patrol-data/
Bondallaz, P., Chtioui, H., Favrat, B., Fornari, E., Giroud, C., & Maeder, P. (2017). On-Road Studies. In Handbook of Cannabis and Related Pathologies. Elsevier Inc. https://doi.org/10.1016/B978-0-12-800756-3/00045-4
Chitas, V., Negreiros, J., & Barreira, T. (2014). Uso de drogas, comportamentos sexuais de risco e comportamentos antissociais na adolescência: Padrões de associação. Psychologica, 57(2), 73–93. https://doi.org/10.14195/1647-8606_57
Daniel, M., Ekenbäck, C., Agewall, S., Brolin, E. B., Caidahl, K., Cederlund, K., Collste, O., Eurenius, L., Frick, M., Younis-Hassan, S., Henareh, L., Jernberg, T., Malmqvist, K., Spaak, J., Sörensson, P., Hofman-Bang, C., & Tornvall, P. (2015). Risk Factors and Markers for Acute Myocardial Infarction With Angiographically Normal Coronary Arteries. American Journal of Cardiology, 116(6), 838–844. https://doi.org/10.1016/j.amjcard.2015.06.011
Drug Enforcement Agency. (2017). Drugs of Abuse: A DEA Resource Guide. US Department of Justice. https://www.dea.gov/sites/default/files/drug_of_abuse.pdf Accessed set. 2022.
Falconi. (2017). Retrato da Segurança Viária 2017 (4th ed.). https://www.ambev.com.br/conteudo/uploads/2017/09/Retrato-da-Segurança-Viária_Ambev_2017.pdf
Favretto, D., Visentin, S., Stocchero, G., Vogliardi, S., Snenghi, R., & Montisci, M. (2018). Driving under the influence of drugs: Prevalence in road traffic accidents in Italy and considerations on per se limits legislation. Traffic Injury Prevention, 0(0), 000. https://doi.org/10.1080/15389588.2018.1500018
Fornari, E., Bondallaz P., Favrat B., & Chtioui H. (2016). Cannabis and its effects on driving skills. Forensic Science International. Forensic Sci Int. 268, 92-102. https://doi.org/10.1016/j.forsciint.2016.09.007
Gibson-Smith, D., Bot, M., Milaneschi, Y., Twisk, J. W., Visser, M., Brouwer, I. A., & Penninx, B. W. J. H. (2015). Marijuana Use is Associated With Worse Outcomes in Symptom Severity and Violent Behavior. Journal of Clinical Psychiatry, 4(September), 4–5. https://doi.org/dx.doi.org/10.4088/JCP.14m09658
Hammersvik, E. (2015). Four barriers and a set of values that prevent violence among cannabis growers. International Journal of Drug Policy, 26(3), 290–295. https://doi.org/10.1016/j.drugpo.2014.08.011
Hartman, H. (2014). Cannabis Effects on Driving Skills. Clinical Chemistry. 59(3), 1–25. https://doi.org/10.1373/clinchem.2012.194381.Cannabis
Hartman, R. L., Brown, T. L., Milavetz, G., Spurgin, A., Gorelick, D. A., Gaffney, G., & Huestis, M. A. (2015). Controlled cannabis vaporizer administration: Blood and plasma cannabinoids with and without alcohol. Clinical Chemistry, 61(6), 850–869. https://doi.org/10.1373/clinchem.2015.238287
Håvard, F., G, J. R. E., Galina, N., Vigdis, V., & Hallvard, G. (2018). Roadside survey of alcohol and drug use among Norwegian drivers in 2016-17: a follow up of the 2008-9 survey. Traffic Injury Prevention, 0(0), 000. https://doi.org/10.1080/15389588.2018.1478087
Ibiapino, M. K., Sampaio, B. P., Souza, R. A. R. de, Padoin, F. A., & Couto, V. B. M. (2017). Serviço de atendimento móvel de urgência : epidemiologia do trauma no atendimento pré-hospitalar. 6–9. https://doi.org/10.23925/1984-4840.2017v19i2a5
Laranjeira, R., Pinsky, I., Caetano, R., Mitsuhiro, S. S., & Madruga, C. (2012). II Brazilian National Alcohol and Drugs Survey. UNIAD: Unidade de Pesquisas em Álcool e Drogas. https://inpad.org.br/wp-content/uploads/2014/03/Lenad-II-Relat%C3%B3rio.pdf Accessed sep. 2022.
Liakoni, E., Gartwyl, F., Ricklin, M., Exadaktylos, A. K., & Krähenbühl, S. (2018). Psychoactive substances and violent offences: A retrospective analysis of presentations to an urban emergency department in Switzerland. PLoS ONE, 13(3), 1–14. https://doi.org/10.1371/journal.pone.0195234
Logan, B. K., D’Orazio, A. L., Mohr, A. L. A., Limoges, J. F., Miles, A. K., Scarneo, C. E., Kerrigan, S., Liddicoat, L. J., Scott, K. S., & Huestis, M. A. (2018). Recommendations for toxicological investigation of drug-impaired driving and motor vehicle fatalities-2017 update. Journal of Analytical Toxicology, 42(2), 63–68. https://doi.org/10.1093/jat/bkx082
Marinho, P., & F Passagli, M. (2013). Toxicologia Forense - Teoria e Prática. Revista Brasileira de Criminalística, 2(1), 52. https://doi.org/10.15260/rbc.v2i1.35
Mascarenhas, M. D. M., & Barros, M. B. de A. (2015). Caracterização das internações hospitalares por causas externas no sistema público de saúde, Brasil, 2011. Revista Brasileira de Epidemiologia, 18(4), 771–784. https://doi.org/10.1590/1980-5497201500040008
Moreau, R. L. de M., & Siqueira, M. E. P. bastos. (2016). Toxicologia Analítica (2nd ed.). Guanabara Koogan.
Papalimperi, A. H., Athanaselis, S. A., Mina, A. D., Papoutsis, I. I., Spiliopoulou, C. A., & Papadodima, S. A. (2019). Incidence of fatalities of road traffic accidents associated with alcohol consumption and the use of psychoactive drugs : A 7-year survey ( 2011-2017 ). Experimental and Therapeutic Medicine. 2299–2306. https://doi.org/10.3892/etm.2019.7787
Pharm, S., A, S. F. B., Gon, C., Botany, M. S., D, S. C. P., & James, C. (2016). Changes in Cannabis Potency over the Last Two Decades (1995-2014 ) - Analysis of Current Data in the United States Short Title Cannabis Potency over the Last Two Decades in USA Department of Computer Science , University of West Georgia ,. Biological Psychiatry. https://doi.org/10.1016/j.biopsych.2016.01.004
Ribeiro, M., Perrenoud, L. O., Duailibi, S., Duailibi, L. B., Madruga, C., Marques, A. C. P. R., & Laranjeira, R. (2014). The Brazilian drug policy situation: The public health approach based on research undertaken in a developing country. Public Health Reviews, 35(2), 1–32. https://doi.org/10.1007/BF03391706
Rutstein, D. D., Berenberg, W., Chalmers, T. C., Child, C. G., Fishman, A. P., Perrin, E. B., Feldman, J. J., Leaverton, P. E., Lane, J. M., Sencer, D. J., & Evans, C. C. (1976). Measuring the quality of medical care. A Clinical Method. New England Journal of Medicine, 294(11), 582–588. https://doi.org/10.1056/NEJM197603112941104
Severino, A. J. (2018). Metodologia do trabalho científico. Ed. Cortez.
Schoeler, T., Theobald, D., Pingault, J., Farrington, D. P., Jennings, W. G., & Piquero, A. R. (2016). Continuity of cannabis use and violent offending over the life course. Psychol Med. 46(8):1663–1677. https://doi.org/10.1017/S0033291715003001
Tice, P. (2017). 2016 National Survey on Drug Use and Health: Detailed Tables. Center for Behavioral Statistics and Quality. https://www.samhsa.gov/data/sites/default/files/NSDUH-DetTabs-2016/NSDUH-DetTabs-2016.pdf Accessed sep. 2022.
UNODC. (2018). Women and Drugs: Drug use, drug supply and their consequences.
Valen, A., Bogstrand, S. T., Vindenes, V., & Gjerde, H. (2017). Increasing Use of Cannabis among Arrested Drivers in Norway. Traffic Inj Prev. 17;18(8):801-806. https://doi.org/10.1080/15389588.2017.1321114
World Health Organization. (2016). Global Status Report on Road Safety (1st ed.). Department of Violence and Injury Prevention and Disability.
Zhao, X., Zhang, X., & Rong, J. (2015). Study of the Effects of Alcohol on Drivers and Driving Performance on Straight Road. Mathematical Problems in Engineering. https://doi.org/10.1155/2014/607652
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Copyright (c) 2022 Kleber Ota de Oliveira; Jessica Yuri Sakurada; Deborah Thais Palma Scanferla; Mariana Aparecida Oliveira Madia; Renata Sano Lini; Marcia Regina Jupi Guedes; Érika Bando; Magda Lúcia Félix de Oliveira; Jorge Juarez Vieira Teixeira; Simone Aparecida Galerani Mossini
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