Alcohol And Other Drugs (AODs)

 

Alcohol And Other Drugs (AODs)

Use Of Alcohol And Other Drugs Has Been Recognized As A Major Independent Risk Factor In Unintentional Fatal And Nonfatal Injuries And In Intentional Injuries Such As Assaults, Homicides, And Suicides. Indeed, Some Clinicians Believe That Traumatic Injury Is A Marker Of Alcohol Abuse .  Although The Role Of Drugs Other Than Alcohol In Traumatic Injuries Has Not Been As Thoroughly Investigated, Studies Have Shown That Cocaine, Amphetamines, And Marijuana, Especially In Combination With Alcohol, Play A Significant Role In Traumatic Injuries Of All Kinds, Especially Motor Vehicle Crashes And Traffic Collision

The Risk Of Injury Is Increased Both By Immediate Use Of Alcohol And Other Drugs (Impairment And Intoxication) And By Chronic AOD Use And The Evidence Of  Alcoholism Has Been Found In Some Samples Of Trauma Patients. Many Aspects Of AODs And Their Effects Play A Role, Including The Following:

The Risk Alcohol And Other Drugs (AODs)

1. AODs Decrease The Level Of Alertness.
2. AODs Impair Motor Function, Diminishing Coordination And Balance And Increasing Reaction Time.
3. AODs Impair Judgment.
4. AODs Impair Perception And Cognitive Abilities.
5. AODs Increase Risk-Taking Behavior And Especially Feelings Of Invulnerability (Especially Among Adolescents And Young Adults).
6. AODs Affect The Emotions And Reduce Inhibitions, Intensifying Feelings Of Anger And Depression And Increasing Impulsivity.
7. Use Of AODs Is Associated With Increased Violent Behavior.
8. Chronic AOD Use Can Render A Person More Medically Fragile, And Thus Injuries Sustained Are More Severe.
9. Obtaining AODs, Especially Illicit Drugs, May Place The Individual In An Unsafe Environment

Untreated AOD Use Disorders Play A Significant Role In Reinjury

Persons Who Experience One Traumatic Head Injury Have Been Found To Be At Greatly Increased Risk For Reinjury. For Example, After One Head Injury, A Person Is Three Times More Likely Than Someone In The General Population To Sustain A Second Head Injury. After A Second Injury, The Relative Risk For A Third Injury Increases To Eight Times The Normal Risk . After One Head Injury, A Person Is Three Times More Likely Than Someone In The General Population To Sustain A Second Head Injury. After A Second Injury, The Relative Risk For A Third Injury Increases To Eight Times The Normal Risk.

.--

DR FIRAS ALKURDI
EMTM, MBBS.

Disease Or Risk Factors In Traumatic Injury

Disease Or Risk Factors In Traumatic Injury

A different approach to this patient group is to view traumatic injuries as a disease, like heart disease, with many potential risk factor . For example, the initial medical workup of a patient who has had a heart attack generally includes several questions related to family history of heart disease, nicotine use, co-morbidity, diet, and level of activity. These questions are asked to clarify the clinical picture and to help the patient understand the underlying cause of his or her condition and the required treatments—and to prevent further illness. A different approach to this patient group is to view traumatic injuries as a disease, like heart disease, with many potential risk factors. Such educational and preventive efforts rarely take place with hospitalized trauma patients whose injuries are related to alcohol and other drug use. However, when injury is viewed as a disease, clinicians are more likely to address underlying risk factors, such as a family history of AOD use, episodes of heavy drinking, and other areas of unsafe behavior such as the failure to use seatbelts.

From the disease perspective, many interacting risk factors contribute to the occurrence of a traumatic event such as a motor vehicle crash. A poorly lit road with dangerous curves increases the risk of a vehicle crash. Add to that icy conditions and an adolescent short on driving experience, attention, and concentration but long on risk-taking behavior, and the risk of a crash increases greatly. Add alcohol consumption to this mix, and from this perspective, the situation appears to be one that almost certainly will end in a crash. When injury is viewed as a disease, clinicians are more likely to address underlying risk factors, such as a family history of AOD use, episodes of heavy drinking, and other areas of unsafe behavior such as the failure to use seatbelts. factors other than AOD use that increase the risk of traumatic injury can be classified into four areas: physical, environmental, socioeconomic, and personality/psychological factors. several factors often interact to contribute to a traumatic injury. Reducing the level of any single factor, such as improving the lighting and paving of roads, can greatly reduce resulting injuries.

Physical factors. Physical factors are those related to the individual person, such as age, gender, and physical health. Younger persons, especially males, are at increased risk of injury because they are generally more active than older persons. Elderly people with poor vision, weak lower extremities, and impaired or decreased balance are at greater risk of falling; because of progressive bone loss they may also sustain severe injuries as the result of relatively low-impact forces.

Environmental factors. Environmental factors increase the risk of traumatic injury. Certain States have passed legislation to reduce speed limits, increase the legal drinking age, and make helmets mandatory for motorcyclists and bicyclists, thereby greatly reducing people's risk of injury. Environmental factors can also relate to an individual's access to guns and use of cars or alcohol and other drugs, as well as to the safety of the person's location, such as his or her living near a body of water or in a high-rise building.

Socioeconomic factors. Socioeconomic factors such as being employed in a high-risk job or living in a high-crime neighborhood or in a poorly maintained building with few safety features also contribute to the risk of traumatic injury. Driving old or poorly maintained cars also increases the risk. Other socioeconomic factors are related to the breakdown of families that is often associated with poverty. Young people may join gangs to replace the family bonds, and enter a culture where violence is promoted and accepted as a routine of daily life.

Personality/psychological factors. Risk taking, antisocial behaviors, and mental illness contribute to risk. Persons who have depression are at increased risk of suicide, and those with schizophrenia or other psychotic disorders may lack the judgment to remove themselves from dangerous situations.

 

DR FIRAS ALKURDI
EMTM, MBBS.