Chemical dependency in patients with burn injuries: a fortress of denial

Chemical dependency is frequently encountered in patients admitted to burn centers. We were interested in the prevalence of chemical dependency among our patients, as well as the rate at which those patients sought further treatment after discharge. Blood and urine specimens were collected within 24 hours of admission from 843 patients more than 18 years of age admitted with acute injuries. Many patients admitted to substance abuse during routine psychosocial evaluation; others admitted only when confronted by the counselor with positive toxicology test results. Of 51 patients counseled, 12 denied a history of chemical dependency. Of the other 39, 21 admitted to a history of chemical dependency, and 31 tested positive for either alcohol or drugs in toxicology screening. Every patient identified with chemical dependency was informed of existing substance abuse programs and given the opportunity to be referred to any of these programs. Only half of the patients who were offered rehabilitation therapy accepted treatment.