Alcohol and Drug Use amongst Maxillofacial Trauma Patients Dr IP Corbett, School of Dental Sciences, Newcastle University, UK

1
Alcohol and Drug Use amongst Maxillofacial Trauma
PatientsDr IP Corbett, School of Dental
Sciences, Newcastle University, UK email
i.p.corbett_at_ncl.ac.uk
INEBRIA 2009
Results

• Introduction
• Research has shown a correlation of alcohol with
  maxillofacial trauma1, however, literature on the
  effects of drug abuse in maxillofacial trauma is
  scarce, despite patients frequently
  self-reporting drug use. Such a trauma population
  may be suited to screening and brief
  intervention.
• Aims
• To determine the prevalence of alcohol and drug
  use in trauma patients attending a UK Accident
  and Emergency department with maxillofacial
  injuries.
• Methods
• Data were collected for 150 consecutive adult
  patients attending an AE department with
  maxillofacial injuries between June and August
  2008. Information relating to presenting injury,
  alcohol and drug intake in the preceding 12 hours
  and alcohol and drug history was recorded.
• Results
• Of 150 patient attendances, 113 were eligible for
  inclusion in the study. The most common age
  group was 21-30years. Soft tissue injury and
  fractured mandibles were the most common injuries
  (76), the most common cause being interpersonal
  violence (71).
• 76 of patients had consumed alcohol within 12
  hours of presentation, mean 12 units. The mean
  reported weekly alcohol intake was 23 units. 10
  of patients reported taking non-prescription
  drugs within 12 hours of injury, the most
  commonly abused drug being cannabis.
• The mean alcohol intake amongst the drug-use
  group was 12 units in the preceding 12 hours, 29
  units per week, similar to that of the non-drug
  users.

• Assault was the mode of injury in 91 patients
  having taken drugs within 12 hours of injury and
  93 with a history of drug use, compared to 66
  of non-drug users. 54 of patients with a
  history of drug use had previously attended with
  a traumatic injury compared to 32 of non-drug
  users.
• Discussion
• Regular drug use was reported in 10 of the
  maxillofacial trauma patients in this study, more
  prevalent than that recorded in the UK general
  population2 Drug users are more likely to
  present with trauma relating to alleged assault
  and demonstrate recidivism.
• Maxillofacial trauma patients are frequently
  treated in the accident and emergency department
  and subsequently discharged. This attendance may
  provide a unique opportunity for screening and
  provision of a brief intervention. Such
  interventions have been shown to be effective in
  a similar trauma population with regard to
  alcohol3. The use of a drugs related brief
  intervention for trauma patients has not been
  reported in the UK.
• A suitable screening and intervention package has
  been developed by the WHO, the alcohol, smoking
  and substance involvement screening test,
  ASSIST4. Field testing of the ASSIST tool in a
  UK maxillofacial trauma population is proposed.
• References
• Warburton AL. Shepherd JP. Alcohol-related
  violence and the role of oral and maxillofacial
  surgeons in multi-agency prevention. Int J Oral
  Maxillofac Surg. 31657-63, 2002.
• Walker A, Kershaw C, Nicholas S. Crime in England
  and Wales 2005/2006. http//www.homeoffice.gov.uk/
  rds/crimeew0506.html
• Goodall, C.A. et al. Nurse-delivered brief
  interventions for hazardous drinkers with
  alcohol-related facial trauma a prospective
  randomised controlled trial. Br J Oral Maxillofac
  Surg, 46 96-101, 2008.
• Validation of the Alcohol, Smoking And Substance
  Involvement Screening Test (ASSIST). Humeniuk R
  et al. Addiction. 103(6)1039-47, 2008.

Weekly alcohol intake
Alcohol intake preceding 12 hours
Frequency of drug use