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Original Articles

Drug and alcohol positivity of traumatically injured patients related to COVID-19 stay-at-home orders

Kirsten N. Younga Department of Surgery, University of California, Irvine, CA, USA

https://orcid.org/0000-0002-2988-0131

Eric O. Yeatesa Department of Surgery, University of California, Irvine, CA, USA

Areg Grigoriana Department of Surgery, University of California, Irvine, CA, USA;b Department of Surgery, University of Southern California, Los Angeles, CA, USA

Morgan Schellenbergb Department of Surgery, University of Southern California, Los Angeles, CA, USA

Natthida Owattanapanichb Department of Surgery, University of Southern California, Los Angeles, CA, USA

Galinos Barmparasc Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA

Daniel Marguliesc Department of Surgery, Cedars-Sinai Medical Center, Los Angeles, CA, USA

Catherine Juillardd Department of Surgery, University of California, Los Angeles, CA, USA

Kent Garberd Department of Surgery, University of California, Los Angeles, CA, USA

Henry Cryerd Department of Surgery, University of California, Los Angeles, CA, USA

Areti Tilloud Department of Surgery, University of California, Los Angeles, CA, USA

Sigrid Burrusse Department of Surgery, Loma Linda University, Loma Linda, CA, USA

Liz Penaloza-Villalobose Department of Surgery, Loma Linda University, Loma Linda, CA, USA

Ann Line Department of Surgery, Loma Linda University, Loma Linda, CA, USA

Ryan Arthur Figuerase Department of Surgery, Loma Linda University, Loma Linda, CA, USA

Megan Brennerf Riverside/Riverside University Health System Department of Surgery, University of California, Moreno Valley, CA, USA

Christopher Firekg Riverside University Health System, Comparative Effectiveness and Clinical Outcomes Research Center (CECORC), Moreno Valley, CA, USA

Todd Costantinih Department of Surgery, University of California, San Diego, CA, USA

Jarrett Santorellih Department of Surgery, University of California, San Diego, CA, USA

Terry Curryh Department of Surgery, University of California, San Diego, CA, USA

Diane Wintzi Department of Surgery, Sharp Memorial Hospital, San Diego, CA, USA

Walter L. Bifflj Trauma Department, Scripps Memorial Hospital La Jolla, La Jolla, CA, USA

Kathryn B. Schafferj Trauma Department, Scripps Memorial Hospital La Jolla, La Jolla, CA, USA

Thomas K. Duncank Department of Surgery, Ventura County Medical Center, Ventura, CA, USA

Casey Barbarok Department of Surgery, Ventura County Medical Center, Ventura, CA, USA

Graal Diazk Department of Surgery, Ventura County Medical Center, Ventura, CA, USA

Arianne Johnsonl Department of Trauma, Santa Barbara Cottage Hospital, Cottage Health Research Institute, Santa Barbara, CA, USA

Justine Chinna Department of Surgery, University of California, Irvine, CA, USA

Ariana Naaseha Department of Surgery, University of California, Irvine, CA, USA

Amanda Leunga Department of Surgery, University of California, Irvine, CA, USA

Christina Grabara Department of Surgery, University of California, Irvine, CA, USA

Jeffry Nahmiasa Department of Surgery, University of California, Irvine, CA, USACorrespondence[email protected]

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ABSTRACT

Background: COVID-19 related stay-at-home (SAH) orders created many economic and social stressors, possibly increasing the risk of drug/alcohol abuse in the community and trauma population.

Objectives: Describe changes in alcohol/drug use in traumatically injured patients after SAH orders in California and evaluate demographic or injury pattern changes in alcohol or drug-positive patients.

Methods: A retrospective analysis of 11 trauma centers in Southern California (1/1/2020-6/30/2020) was performed. Blood alcohol concentration, urine toxicology results, demographics, and injury characteristics were collected. Patients were grouped based on injury date – before SAH (PRE-SAH), immediately after SAH (POST-SAH), and a historical comparison (3/19/2019-6/30/2019) (CONTROL) – and compared in separate analyses. Groups were compared using chi-square tests for categorical variables and Mann-Whitney U tests for continuous variables.

Results: 20,448 trauma patients (13,634 male, 6,814 female) were identified across three time-periods. The POST-SAH group had higher rates of any drug (26.2% vs. 21.6% and 24.7%, OR = 1.26 and 1.08, p < .001 and p = .035), amphetamine (10.4% vs. 7.5% and 9.3%, OR = 1.43 and 1.14, p < .001 and p = .023), tetrahydrocannabinol (THC) (13.8% vs. 11.0% and 11.4%, OR = 1.30 and 1.25, p < .001 and p < .001), and 3,4-methylenedioxy methamphetamine (MDMA) (0.8% vs. 0.4% and 0.2%, OR = 2.02 and 4.97, p = .003 and p < .001) positivity compared to PRE-SAH and CONTROL groups. Alcohol concentration and positivity were similar between groups (p > .05).

Conclusion: This Southern California multicenter study demonstrated increased amphetamine, MDMA, and THC positivity in trauma patients after SAH, but no difference in alcohol positivity or blood concentration. Drug prevention strategies should continue to be adapted within and outside of hospitals during a pandemic.

KEYWORDS:

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Drug and alcohol positivity of traumatically injured patients related to COVID-19 stay-at-home orders

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Drug and alcohol positivity of traumatically injured patients related to COVID-19 stay-at-home orders

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