Risk of injury from alcohol and drug use in the emergency department: A case-crossover study


Cheryl J. Cherpitel DrPH, Senior Scientist, Yu Ye MA, Biostatistician, Katie Watters MPH, Research Associate, Jeffrey R. Brubacher MD, MSc, FRCPC(EM), Assistant Professor, Rob Stenstrom MD, PhD, CCFP(EM), Director of Research, Clinical Assistant Professor. Dr Cheryl J. Cherpitel, 6475 Christie Avenue, Suite 400, Emeryville, CA 94608, USA. Tel: +1 510 597 3453; Fax: +1 510 985 6459; E-mail: ccherpitel@arg.org


Introduction and Aims. A substantial literature exists demonstrating the risk of injury from alcohol, but less is known about the association of alcohol in combination with other drugs and injury. This study examined the risk of injury associated with alcohol and drug use prior to the event.

Design and Methods. Case-crossover analysis was used to estimate the relative risk (RR) of injury due to alcohol use alone, compared with alcohol in combination with other drug use in a sample of emergency department injured patients from two sites in Vancouver, British Columbia (n = 443). Alcohol and drug use in the 6 h prior to injury was compared with the patient's use of these substances during the same 6 h period the day prior and the week prior to injury.

Results. Using multiple matching for the two control time periods, RR of injury was significantly related to both alcohol use (RR = 3.3) and to alcohol combined with drug use (RR = 3.0), but not to drug use alone. Effect modification was found only for age for alcohol combined with drug use, with a significant increase in injury risk (P = 0.087) for those over 30.

Discussion and Conclusion. While a similar elevated risk of injury was found for alcohol use alone and alcohol used with other drugs, the literature suggests that alcohol in combination with some drugs may be potentially more risky for injury occurrence. Findings suggest the need for future research on risk of injury for specific alcohol and drug combinations.[Cherpitel CJ, Ye Y, Watters K, Brubacher JR, Stenstrom R. Risk of injury from alcohol and drug use in the emergency department: A case-crossover study. Drug Alcohol Rev 2012;31:431–438]