Substance use among emergency room patients: an exploratory analysis by ethnicity and acculturation.
OBJECTIVE: While substantial literature exists on the role of alcohol in injury occurrence, little is known about other substance use or abuse and injury, or drug use among the alcohol involved at the time of the emergency room (ER) visit. METHOD: A probability sample of 1,429 patients attending the ER at Santa Clara Valley Medical Center (CA) was interviewed and was asked questions pertaining to licit and illicit drug use and alcohol use within 6 hr prior to the event, and drug use within the last year. RESULTS: While drug use within the 6 hr prior to the event was not found to be significantly different between injured and noninjured patients, injured patients were more likely to report drug use during the last year, and those with violence-related injuries were more likely to report drug use during both time periods compared to those with other injuries. Drug use was associated with ethnicity, with whites more likely than blacks or Hispanics to report use. Among Hispanics, acculturation was related to drug use, with those high on acculturation as likely or more likely than whites to report use. Among those reporting alcohol consumption within 6hr prior to the event and those meeting criteria for alcohol dependence, differences across ethnic/acculturation subgroups for drug use in the same 6-hr period were not significant, and a higher prevalence of both 6-hr and 12-month substance use was found compared to those not reporting drinking during the 6 hr and those not alcohol dependent. CONCLUSIONS: Data suggest that ethnic differences in substance use becomes less important among those alcohol involved, and future research should focus on the interaction of alcohol and other substances on injury occurrence. Data also suggest that substance use associated with increasing acculturation among U.S. Hispanics may have a strong impact on health services utilization, and research is needed by gender, ethnicity, and acculturation to determine the burden that substance use places on the ER.