Accidents and Injuries from Drugs

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Injury is a major cause of death across the age spectrum, and the leading killer of Americans aged 1 through 44 years. Scientists frequently identify the causes of injury as a combination of risky behavior and hazardous environments. Risk-taking behavior and injury are especially common during adolescence and young adulthood. Drug use contributes to injuries among adolescents and young adults because it has negative effects on perception, judgment, and reaction time. A young person under the influence of drugs also has less respect for the welfare of self and others.

The field of research that explores the relationship between injury and drugs other than alcohol is relatively new. This research has been greatly aided by improved drug testing, which allows investigators to detect drugs in samples of blood, urine, saliva, sweat, or hair. Most of this research occurs in facilities such as hospital trauma centers and emergency departments, where more severely injured victims receive treatment. Other important research is conducted by medical examiners who test for the presence of drugs during an autopsy, which is the close investigation of a deceased person's body to determine the cause of her or his death. In the case of questionable deaths, autopsy results can lead medical examiners to conclude that injury was thecause. They can then rule these injury deaths as homicides or suicides (intentional injury) or accidents (unintentional injury).

This X-ray shows an ankle fracture, with the leg horizontal. One study found that a person who abuses drugs is three times more likely than a person who abuses neither alcohol nor drugs to be injured severely enough to visit the hospital.

Just as drinking and driving create a dangerous mix, illegal drug use poses severe threat of injury to drivers and others on the road with them. A landmark Tennessee study found that over half of drivers stopped by police for reckless driving who tested negative for alcohol use were actually intoxicated with drugs. The drugs most frequently detected were cocaine and marijuana. The United States and many other countries are reporting rising numbers of injured motorists testing positive for marijuana, cocaine, amphetamines, or other illegal drugs. These trends probably reflect both real changes in driving under the influence of drugs and the improving capability of police to test drivers for drugs.

An American study on nonfatal injury compared 15,000 substance abusers between the ages of 10 and 64 with a group of 75,000 nonabusers to see if their injury patterns varied. Abusers were more likely to be injured than non-abusers. Of subjects categorized as both drug and alcohol abusers, 58 percent sustained an injury over the three years of observation. This compared to 49 percent of those who had abused drugs only, 46 percent of those who had abused only alcohol, and 39 percent of those who had abused neither. With non-abusers as the base of comparison, the likelihood of hospitalization for an injury was four times higher among the combined drug and alcohol abuse group, three times higher among the drug abusers, and twice as high among the alcohol abusers.

Another study conducted in three large metropolitan areas of the United States showed that illegal drug use strongly increased the likelihood that users would meet a violent death—in other words, die from intentional injury. This study looked at marijuana, cocaine, heroin, amphetamines, and barbiturates. The study found that drug users were seven times more likely than non-users to commit suicide, and five times more likely to be murdered. Subjects using both drugs and alcohol were seventeen times more likely to commit suicide, and twelve times more likely to die from homicide than non-users.

A drug overdose is the misuse of drugs in amounts so high that a person can fall asleep, become unconscious, lapse into a coma, or die. Overdoses are in fact a form of poisoning. Most drugs can be deadly when taken in large quantities, whether swallowed, inhaled, or injected intravenously. Drugs such as heroin, methadone, cocaine, opioids, benzodiazepines, amphetamines, and "designer" or "club" drugs such as ecstasy can all lead to an overdose. Combining drug and alcohol use is an extremely common cause of overdoses. Even caffeine, a drug that public health professionals consider relatively harmless in terms of causing injuries, has caused fatal overdoses when people have taken huge doses in the form of pills. Whether unintentional or intentional, drug poisonings are especially harmful to the young.

An unintentional injury is not an accident. Both unintentional and intentional injuries can be predicted and prevented. For example, routine use of trained lifeguards and secured locks at public swimmingpools would help prevent drowning caused by drug intoxication. Drug screening, prevention, and treatment programs must be central parts of a comprehensive public health strategy aimed at reducing, and eventually eliminating, the burden of injury on society as a whole.

Accidents and Injuries from Alcohol; Driving, Alcohol, and Drugs; Medical Emergencies and Death from Drug Abuse; Suicide and Substance Abuse.