Association between the detection of alcohol, illicit drugs and/or psychotropic medications/opioids in patients admitted due to trauma and trauma recidivism: A cohort study

PLoS One. 2018 Sep 12;13(9):e0203963. doi: 10.1371/journal.pone.0203963. eCollection 2018.


Objective: To quantify the association between the presence and type of drug detected and trauma recidivism in a cohort of patients admitted due to trauma.

Method: A cohort study was conducted based on data from a project where the presence of alcohol and other drugs (cannabis, cocaine, amphetamines, methamphetamines, tricyclic antidepressants, barbiturates, opiates and benzodiazepines) was analysed in 1,187 patients aged 16 to 70 years admitted due to trauma. The patients were followed for a period of between 10 to 52 months until June 2016. For this study, the recurrence of injuries from a sample of 929 patients from this cohort was analysed according to their consumption profile. Survival curves were estimated and adjusted Hazard Rate Ratios (aHRR) and adjusted incidence rate ratios (aIRR) were calculated.

Results: The incidence rate of TR was 10.94 cases per 100 patient-years in the group of patients negative for substances and 27.99 per 100 patient-years in positive patients. The survival curves show very significant differences in cumulative recurrence-free survival between the groups (Log Rank: p<0.001). Both the aHRR and the aIRR estimates show an increased risk of re-injury due to alcohol consumption (aIRR: 2.33 (1.72-3.15), p<0.001), cannabis use (aIRR: 1.87 (1.09-3.20), p = 0.022) and polydrug use (aIRR: 2.34 (1.80-3.04), p<0.001).

Conclusions: The presence of alcohol and/or illicit drugs in these patients doubles the risk of trauma recidivism.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Alcohol Drinking / adverse effects*
  • Analgesics, Opioid / adverse effects*
  • Cohort Studies
  • Female
  • Humans
  • Illicit Drugs / adverse effects*
  • Male
  • Marijuana Smoking / adverse effects
  • Middle Aged
  • Psychotropic Drugs / adverse effects*
  • Recidivism
  • Recurrence
  • Risk Factors
  • Spain
  • Substance-Related Disorders / complications
  • Wounds and Injuries / etiology*
  • Young Adult


  • Analgesics, Opioid
  • Illicit Drugs
  • Psychotropic Drugs

Grants and funding

This work was supported by the Dirección General de Tráfico, Spain [grant number: 0100DGT22389] ( The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.