The Association Between Psychoactive Substances Usage and Unintentional Injuries After Traumatic Spinal Cord Injury

In the United States, unintentional injuries (UIs) are a leading cause of healthcare utilization, disability, and mortality. Among adults with traumatic spinal cord injury (TSCI), subsequent UIs are often reported and have been recognized as the sixth leading cause of death after TSCI. There is a need to better understand the potential role of psychoactive substances (PASs) on UIs among people with TSCI.

To examine the occurrence of fall-related and non-fall-related UIs at the first Form II follow-up assessment after being discharged from inpatient rehabilitation and identify the relationships between PAS usage (excluding alcohol) and different types of UI.

Adults with TSCI were identified from the SCI Model Systems (SCIMS). Data on self-reported UIs were collected and linked with the SCIMS data collected at admission to inpatient rehabilitation and year 1 follow-up, including clinical and demographic characteristics and self-reported PAS usage measured using the World Health Organization (WHO) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) Phase II. We developed 2 logistic regression models to investigate the association between PAS usage and fall-related UIs and non-fall-related UIs.

Among the 316 participants, 15% had at least one UI in the past year. PAS usage was significantly associated with fall-related UIs but not with non-fall-related UIs, after adjusting for injury and demographic covariates.

To prevent subsequent fall-related UIs after SCI, healthcare providers should assess and closely monitor people's PAS usage, especially for people who are ambulatory.