Abstract
IntroductionEmergency department (ED) visits for mental health and substance use disorders have been on the rise, with substance use disorders frequently coexisting with mental health disorders. This study evaluated substances commonly used/abused by patients presenting to the ED of a rural, regional medical center with subsequent admission for mental health treatment in Robeson County, North Carolina.MethodsThis retrospective, single-center study was approved by the Southeastern Health Institutional Review Board. We reviewed medical records of psychiatric patients presenting to the ED with ultimate admission to the inpatient psychiatric unit between January 1, 2016, and June 30, 2016. Frequencies of controlled substances testing positive on urine drug and alcohol screenings in admitted patients were obtained and analyzed. We also made ethnic and gender comparisons.ResultsA total of 477 patients met inclusion criteria. The percentage of patients testing positive were as follows: tetrahydrocannabinol (THC) (40%); cocaine (28.7%); alcohol (15.1%); benzodiazepines (13%); opiates (9.6%); amphetamines (2.9%); barbiturates (2.3%); and methadone (0.8%). A relatively higher proportion of patients tested positive for THC than any other substance (p≤.0002). We found statistically significant differences for gender (p=.0004) and ethnicity (p<.0001) compositions regarding substance use/abuse.ConclusionThe majority of admitted psychiatric patients in this study tested positive for at least one controlled substance. The two substances that most often returned positive on the urine drug screen test in our sample were THC (marijuana) and cocaine. These findings may provide insight into concomitant substance abuse and psychiatric disorders, which could instigate public policy development of preventative health initiatives that explore the relationship between controlled substance use/abuse and mental health disorders in rural counties like Robeson County.
Highlights
Emergency department (ED) visits for mental health and substance use disorders have been on the rise, with substance use disorders frequently coexisting with mental health disorders
These findings may provide insight into concomitant substance abuse and psychiatric disorders, which could instigate public policy development of preventative health initiatives that explore the relationship between controlled substance use/abuse and mental health disorders in rural counties like Robeson County. [West J Emerg Med. 2019;20(2)419-425.]
We explored the rate of controlled substance use/abuse among psychiatric patients who presented to the emergency department (ED) in a rural North Carolina regional medical center
Summary
Emergency department (ED) visits for mental health and substance use disorders have been on the rise, with substance use disorders frequently coexisting with mental health disorders. As the gatekeeper of the healthcare system, the emergency department (ED) serves as the safety net for most Americans, especially the uninsured, low socioeconomic status, and medically underserved populations. The ED is a primary entry point to the healthcare system for many patients who are unable to access care in outpatient centers.[1] Patients with mental health and substance addiction issues. The combination of mental health issues and substance abuse contributes to the complexity of care and management of such patients.[2] In light of this, emergency physicians and psychiatrists may need to acquire more knowledge about the issue to understand better the nuances involved in the care of this unique population
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