A case-control study of alcohol and substance use disorders as risk factors for non-fatal injury

While alcohol use is thought to be a major risk factor for both fatal and non-fatal injuries, the association of substance use disorders (alcohol use disorders, AUD and substance use disorders, SUD) with occurrence of injury has not received the same attention. To report the association of AUD and SUD, according to diagnostic and statistics manual of mental disorders-IV (DSM-IV) and international classification of diseases 10 (ICD-10) criteria, and the risk of non-fatal injuries.

A case-control study: Cases included 653 injured patients, 18-65-years-old, who attended one emergency department (ED). Controls included 1131 subjects from a representative sample of residents of Mexico City, of the same age group. Information on drug and alcohol use was obtained by interview using the world mental health version of the composite international diagnostic interview (WMH-CIDI).

Among injured patients, the prevalence of substance abuse or dependence within the last 12 months was 12.3% for alcohol and 2.5% for other substances (marijuana, cocaine, tranquilizers, amphetamines, others). Among residents of Mexico City, these prevalences were 1.8 and 0.3%, respectively. Adjusted odds ratios (OR) of injury according to alcohol and substance use were 4.95 (95% confidence interval (CI): 2.87-8.52) for alcohol and 2.58 (0.73-9.17) for other substances. An important level of comorbid alcohol and substance use disorders was also found.

Efforts in the ED should be carried out to treat and/or refer patients with alcohol and substance use disorders, and special care should be taken to address comorbid cases.