الفهرس 
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Abstract
Substance abuse is a root cause of violence and other injuries .it possess health and safety hazards both in the workplace and in the wider community. Many drug abusers are forced to commit homicidal assaults or robbery to obtain money necessary for drugs. Others may commit crimes while they are under the influence of these drugs
Trauma is a serious problem worldwide, particularly affecting the young. Trauma results in production loss in addition to being a health problem. It is also the leading cause of death in people from 1 to 44 years of age, while it is in the third leading cause for all age groups
In Egypt, little is known about pre injury use of illicit drugs in trauma patients so the present work aimed to determine the prevalence of some commonly used illicit drug of abuse among 300 trauma patients presented to sohag university hospitals.
The obtained data was documented and recorded in a special sheet constructed for each patient.
The sheets recorded the following data for each patient:
• Sociodemographic data.
• Clinical data.
• Investigational data.
After statistical analysis, the results were as follows:
Age between (14-21years) and between (22-35years) constituted about 34.6% and 36 % respectively of whole cases in the current study.
The male percentage was higher than female one (96.3%) and (3.7%) respectively. 57.7% of patients came from rural areas and the rest came from urban areas (42.3%). Manual workers were the most affected group (38%) as well as farmers (20.4%).patients with primary education was the most affected group (39.3%).
In the current study street constitutes about (768%) followed by home (14%) and workplace (10%). The main cause of trauma was road traffic accidents (70.3%) followed by interpersonal violence (15.7%) and finally fall from height (14%).
In the current study the most common mode of trauma was unintentional trauma by (84.3%)
The majority of cases under the study were normotensive. Regarding pulse, 6.7% of cases presented with tachycardia. Regarding respiratory rate (12.7%) of cases presented with bradypnea while hypothermia was in (3%).
In the current study most patients had mild trauma (revised trauma score <7.2).
In the current study the Prevalence of drug abuse according to urine test results was 15.3% among all studied trauma patients and the most abused drug was tramadol (8.6%) followed by tetrahydrocannabinol (THC) (4.6%) then benzodiazepines (BZDs) (3.3%), while opium (0.6%), finally amphetamine and barbiturates weren’t found in any trauma patients. Polydrug users among the abusing trauma patients were about 10.9% which were only males and tramadol was the common drug to use in poly drug users.
• There was a highly statistically significant relationship between drug abuse and mode of trauma.
• There was no statistically significant relationship between drug abuse and residence of trauma patients.
• There was no statistically significant relationship between drug abuse and age of trauma patients.
• There was a highly statistically significant relationship between drug abuse and severity of trauma.
• There was a highly statistically significant relationship between drug abuse and level of consciousness.
• There was a highly statistically significant relationship between drug abuse and having a history of previous trauma.
Conclusions
• from this study 14-21 years old and 22-35 years old are the risky age groups affected by trauma due to drug use and males are more predominant than females.
• Trauma occurs more frequently at rural areas.
• Manual workers were the most affected occupation.
• Street was the most common place of trauma.
• Road traffic accidents were the most common cause of injury.
• Unintentional injury was the most common mode of trauma.
• Most patients had mild trauma.
Tramadol was the commonest drug of abuse followed by THC.
Recommendations
Prevention is the successful solution of trauma problem so documentation of the prevalence of substance abuse is one of major factors to solve this problem. This documentation will give us information about the magnitude of the problem of drug abuse and its effect on occurrence of trauma and help us to establish planning intervention programs for drug abuse problem which will decrease the occurrence of trauma.
The following are recommended to face the problem of substance abuse and trauma
1. All trauma patients should be tested for drug abuse and this testing will aid in clinical management and identifying patients at risk of withdrawal during treatment and identify patient at risk of recurrent trauma.
2. Establish substance abuse and trauma prevention curriculum education to all medical students, surgery residents. This curriculum will include identification of substance abuse disorder and treatment options.
3. Clinicians should have a role in generating identification and treatment protocols for substance abuse disorder among their patients by
Performing routine substance abuse screening for all trauma patients
Reporting the result on regular basis
Referring positive patients for evaluation and treatment of addiction
4. Clinicians should avoid the problem of iatrogenic dependence
5. Trauma centres should assess the efficacy of substance abuse intervention, prevention and treatment strategies.
6. Clinicians should have a role in community based injury prevention programs especially those concerned with the association of drug abuse, violence and road traffic accidents.
7. Drug enforcement laws are helpful to prevent substance abuse by performing obligatory careful drug abuse testing before employment and before getting drive licence.
8. Obligatory and sudden testing of drug abuse for drivers, violent injuries and road traffic accidents.
9. Teaching the community based programs for prevention of drug abuse for adolescents in school, mosques, churches and clubs.
10. Law and security agencies should increase keeping their eyes on drug dealers and increase the punishment of them.