Urine drug screen trends from 1998 through 2011 among emergency department patients treated in a University Teaching Hospital

ABSTRACT

The emergency department (ED) at Louisiana State University-Health Science Center in Shreveport (LSUHSC-S) serves an urban population with a large rural catchment area. This study focuses on demographic variables in substance abuse trends in this region based on urine drug screen (UDS) results. A database of de-identified UDSs ordered in the ED at LSUHSC-S between 1998 and 2011 was analyzed. Samples were tested for the presence of amphetamines, barbiturates, benzodiazepines, cannabinoids, cocaine, 3,4-methylenedioxymethamphetamine (MDMA), methadone, methamphetamine, opiates, phencyclidine, and propoxyphene. The patient population was categorized by age group, gender, and race. The majority of tests were performed on African-American and Caucasian patients aged 18–54 followed by the 0–11-year-old group. Of the drugs tested, cannabinoids represented the highest percentage of positive results in both the African-American and Caucasian populations. Opiates returned the highest percent of positive results among all prescription drugs. The Caucasian population predominated in positive tests for prescription drugs (opiates and benzodiazepines), while the African-American population predominated in results positive for illicit drugs (cannabinoids and cocaine). The increasing presence of opiates and cannabinoids, particularly in very young patients, should prompt policy-makers and health care providers to develop intervention strategies to protect the most vulnerable populations.

KEYWORDS:

• Urine drug screening
• emergency department
• administrative database

Acknowledgments

We thank Barry Dobbins for collecting the data and the Department of Pharmacology, Toxicology and Neuroscience and the Department of Emergency Medicine for supporting the data collection and analysis. Linda J. Kesselring, MS, ELS, copyedited the manuscript.

Disclosure statement

The authors declare that they have no competing interests. The authors alone are responsible for the content and writing of this article.

Additional information

Funding

National Institute of General Medical Sciences of the National Institutes of Health [award number P30GM110703 (recipients are Dr Urska Cvek and Dr Marjan Trutschl)], [award number P20GM103424 (recipient is Dr Marjan Trutschl)]; the Noel Foundation (award holder is Dr Marjan Trutschl); the Abe Sadoff Distinguished Chair in Bioinformatics for Dr Marjan Trutschl; and the Lisa Burke Bioinformatics Endowed Professorship for Dr Urska Cvek; the Shreveport/Bossier SCI-NET Post-Katrina grant (recipient is Anna Leskova).