الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Substance abuse simply indicates improper use of illegal substances, drugs and /or prescription medications with potential harmful consequences to the individual and society. It is very common and affects all ages and classes of patients. Patients with substance abuse are more likely to suffer injury than others. Aim: The present work aimed to determine the prevalence of some illicit substances of abuse among 150 trauma victims presented to Mansoura Emergency Hospital. Patients and Methods: All patients were subjected to thorough history taking regarding some demographic data; place, mode, cause and repetition of injury. Complete medical examination and radiological investigations were done to determine both type of injury and injury severity score. Forty ml urine was obtained from each patient for toxicological analysis. EMIT was used for rapid preliminary screening of some substances of abuse. Thin Layer Chromatography (TLC) was used to confirm the results of EMIT for opiates, benzodiazepines, barbiturates, cannabis, amphetamines. Results: The most common substances detected were cannabis which were found in 59.3% of cases followed by opiates (38%), alcohol (10.7%), benzodiazepines (6.7%), amphetamines (2.7%) and barbiturates (1.3%). Tramadol was the most frequent type of opiates detected. There was a high prevalence of substance abuse among adolescents who were single, smokers, with intermediate educational level. Most patients were students, drivers and manual workers. Road traffic accident (RTA) was the major cause of injury. RTA was the most common cause of injury in cannabis and opiates positive cases. There was a highly significant statistical association between cannabis detected in trauma patients and RTA. Conclusion: Preinjury use of illicit substances and alcohol is ubiquitous among injured patients treated in trauma centers. Recommendations: 1) Clinicians should be aware of the possible association between substance abuse; violence and trauma. 2) The documentation of the presence of alcohol and substance abuse is key aspect in the prevention of injury. 3) All patients admitted for treatment of injuries should be tested for drugs and alcohol. 4) Drug enforcement laws are helpful to curtail substance use. 5) Mandatory medical examination and drug testing should be done for all persons before employment and before getting a driving license. 6) Regular and sudden testing is essential for drivers, athletes, persons involved in assaults, injuries in the workplace, violent injuries and road traffic accidents.