Alarming Rate of Substance Use in Motor Vehicle Collisions at an Appalachian Trauma Center

Rebecca Proctor,Megan Quinn,Melissa P Taylor,Bracken Burns

doi:10.7759/cureus.11863

Rebecca Proctor, Megan Quinn + Show 2 more

Open Access

https://doi.org/10.7759/cureus.11863

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Journal: Cureus	Publication Date: Dec 3, 2020
Citations: 2	License type: cc-by

Affiliation: East Tennessee State University

Abstract

Prescription drug use is a growing public health concern and studies show it is a contributing risk to motor vehicle collisions. The Appalachian region is also known to have an ever-increasing number of patients on controlled substances. This retrospective study of patients from the years 2011-2015 on controlled substances presenting to an Appalachian Level 1 trauma center after a motor vehicle or motorcycle collision was analyzed in order to determine the rate of opioid use among victims of motor vehicle collisions in the system, as well as evaluate for any differences in resource utilization between these patients and patients not using controlled substances.A total of 2,570 patients were included in the study. Seven-hundred sixty-eight (29.9%) individuals were found to be on a controlled substance. There was a similar mortality rate in both groups (2.8% vs 3.6%). There was no significant difference in hospital length of stay (LOS), intensive care unit (ICU) LOS, ventilator days, or injury severity score. Statistically significant findings include the type of crash (motor vehicle crash vs motorcycle crash) (p=0.003) and position in the vehicle (driver vs passenger) (p<0.001). Motor vehicle crashes and driver position were significantly associated with the presence of a controlled substance.

Highlights

The most recent published data from the National Highway Traffic Safety Administration (NHTSA) indicates a national increase of 6% traffic fatalities per year or 11.59 fatalities per 100,000 people
Controlled substance use was categorized as “yes” if the patient selfreported controlled substance use, the medical record indicated the patient was on controlled substances, or the toxicology screening was positive for controlled substance use prior to the administration of opioid medications
With growing public health concerns regarding both controlled substance use and increasing motor vehicle fatalities, we aimed to evaluate the rate of controlled substance use in patients presenting to an Appalachian level 1 trauma center after a motor vehicle collision as well as their in-hospital outcomes

Summary

Introduction

The most recent published data from the National Highway Traffic Safety Administration (NHTSA) indicates a national increase of 6% traffic fatalities per year or 11.59 fatalities per 100,000 people. In the state of Tennessee, this increase of fatalities was found to be even higher than the national average, with a rise of 8% contributing to 15.65 fatalities per 100,000. Of the factors identified to be related to this increase in fatalities, driving too fast (17.8%) and being found to be under the influence of alcohol, drugs, or medication (10.8%) were the most commonly cited. Seven percent to 15% of drivers involved in traffic fatalities tested positive for illegal drugs or prescription medications [1]. Guohua and Chihuri found that opioid use significantly increased the rate of fatal crash involvement, independent from alcohol use [3]

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