Alcohol or Substance Use and Recidivism in Trauma

Alcohol or Substance Use and Recidivism in Trauma

Research problem

The very well-known causes of trauma are psychotropic medicines, illicit drugs, and alcohol. Nevertheless, the association between recidivism in injury and every type of substance is still unclear. Previously trauma was considered an irregular event, which later translated and was termed as a chronic disease.

Additionally, for many years’ knowledge had it that a section or trauma patients in hospitals had a record of previous cases of trauma, which was still termed as trauma recidivism. The study seeks to identify the relationship between a patient diagnosed for trauma and the history of those patients having trauma before. If this relation determined and the study proves the relationship, nurses and other health practitioners will easily diagnose trauma and probably come up with a permanent and advance medication for such patients. The main purpose for carrying this research was to measure and determine how strong is the association between the substance type spotted in patients admitted in hospitals and their traumatic damage and trauma recidivism (past history of trauma).

Literature Review

There are possibilities of subsequent traumatic brain injury, which can be influenced by alcohol consumption even without a history of brain injury (Vaaramo, Puljula, Tetri, Juvela, & Hillbom 2014). Analysis of recidivists in large Canadian cities can help identify the risk factors of major trauma (Caufeild et al., 2004). Trauma is still one of the major shocking diseases that affect Americans. Although trauma recidivism characteristics have been identified, further studies are requiring tests likely interventions to control the needless trauma injuries which occur on a daily basis (Keough Lanuza Jennrich Gulanick  & Holm K.2001). The article has used old and recent references for its study, for example, an occurrence of alcohol-based trauma recidivism (Nunn, Erdogan & Green 2016). This reference was used because of its relevance to the topic of study. Another example is a study that recurrence of trauma disease (Poole G. V., Griswold J. A., Thaggard V. K., & Rhodes R. S. (1993). This was used in this study to gather past information about trauma recidivism.

Theoretical Framework

Apparently, apart from the scholarly studies and other related researches, there no theories that have tried to explain trauma recidivism nor the association of it with alcohol, drug, and substances. Although this is a nursing study article, it has widely borrowed for the discipline of alcohol and drug substance. The reason for this is because the health condition being studied and researched is directly related to alcohol and drug substance. The fact that there no theories defining how trauma recidivism could be related to drug and substance, then the article could also not have stated the theoretical framework. A good theory would be the theory of trauma recidivism, which would state that alcohol, drug, and substance causes trauma recidivism.

Variables, hypothesis, assumptions, and questions

Drug screening

The presence of substances like cannabis, methadone, benzodiazepines, barbiturates, amphetamines, methamphetamines, tricyclic antidepressants. All were screened in urine with fluorescence immunoassay. Patients’ medical records were then reviewed, followed by questioning to differentiate those who tested positive for opioids and benzodiazepines due to emergency treatment an those who have used substances before seeking medical. The presence of alcohol was tested by food analysis and blood levels. Additionally, patients whose blood could not be taken, and honestly, they admitted to taking alcohol, were regarded as positive.

Clinical data and trauma recidivism

Other clinical data like gender, age, trauma recidivism, psychiatric disorder, the severity of the injury, injury mechanism, and hospital deaths were obtained from patient’s medical records. Overall, patients’ records of trauma and psychiatric diagnosis disorders were obtained digitally from the record by Andalusian Health Service Database since 1999. The hypothesis is not clearly stated in the study.

Methodology

The method used for this is the quantitative method as well as deductive reasoning, which involved the collection and analysis of numerical data. The technique involved a cross-section study carried out to analyze the relationship between present drug and substance use and recidivism in trauma in patients who were admitted to the University hospital of Granada in Spain. Since 2011, the research group had established a program in that hospital for screening, short-term briefs, intervention, and transfer for drug-related and alcohol trauma patients. This was a comprehensive method for treating people with substance and drug abuse problems. The brief intercession was offered to only patients who did not have prior clinical conditions, which might have affected the spinal cord injury, mental disorder, post-traumatic brain injury, or death when they were in the hospital.

The information used in this study was gotten from Screening Brief Intervention and Referral Treatment (SBIRT). Both monitoring and clinical data were used. The study used a physical study setting in which a sample size amounted to 1798 patients who were eligible to be included in this program through a simple random sampling method. Being in the study population was considered that the patient was recruited when the study was in progress and was admitted to the hospital for traumatic injuries within the 32 months the program was in operation. This selection was made through the non-probability selection method.  Throughout the study, the most reliable tools that were used in examinations of the patients were by use of clinical equipment, for example, in the testing urine and the blood tests. Generally, clinical tools give legitimate, credible, and reliable information. Although the patients who got admitted for trauma disorders got screened for various substances in their body, the study doesn’t indicate whether any patient’s consent was needed before undertaking the procedure or it was a mandatory activity for them. With this in mind, it is hard to tell whether all required ethics were used.

Data collection for this study was through testing, screening, and use for questionnaires various substance in patients. This kind of data analysis is known as quantitive analysis. The analyzed data was then presented by the use of flow charts showing the patients who took part in the study. Further analysis was used to establish a median age that constituted of the substances tested, an interquartile group, which results showed that it was majorly constituted of women. More than half of the patients admitted during the study had a history of falling onto the ground surface. Additionally, the injury was predominant in the age above 16 years, the group known as polydrug group and alcohol consumers who had a high level of mortality. A table was also used to indicate the characteristics of the participants by the group.

Strengths and limitations

The strength of this data collection in this study was not affected by biasness as there use of questionnaires and records from the registry. Additionally, the study was specific on the age group needed to collect data from 16-70 years old and also involved implementation of the SBIRT program to carry out the screening. This approach removed the biasness that could be there id the physicians had decided to carry out overall testing without selection.

The main limitation is that the study does not allow validation of causal diversity of relationship pattern of using drugs and the Trauma recidivism, the association results were done in a backward direction and only established after the identification of the outcome. Another limitation was that there could be false information about it. This is because alcohol couldn’t have been possible that it was exposed to all patients. In some cases, the researcher forced to rely on self-reporting by the patients themselves. It is also good to note that this bias was also present in past studies.

The results of this study cannot be used to generalize other populations because, during the program, there was an adjusted relation between the use of psychotropic medication and trauma recidivism, which is a recognized risk influence for traumatic injury.

Conclusion

New findings were that a multi recidivism association is stronger than single recidivism for any substance one is exposed to. It was also identified that alcohol had the lowest association with trauma recidivism while in cocaine, it was the highest.

The frequency for trauma recidivism was high in patients who were between 16-70 years of age, who tested positive for alcohol, psychotropic medications, and drugs compared to those who tested negative. The study suggests that deeper knowledge will be required on the point that different substances have an effect on Trauma recidivism.

References

Vaaramo K., Puljula J., Tetri S., Juvela S., & Hillbom M. (2014). Head trauma sustained under the influence of alcohol is a predictor for future traumatic brain injury: A long-term follow-up study. European Journal of Neurology, 21, 293–298. doi:10.1111/ene.12302

Keough V., Lanuza D., Jennrich J., Gulanick M., & Holm K. (2001). Characteristics of the trauma recidivist: An exploratory descriptive study. Journal of Emergency Nursing, 27, 340–346. doi:10.1067/men.2001.116214

Caufeild J., Singhal A., Moulton R., Brenneman F., Redelmeier D., & Baker A. J. (2004). Trauma recidivism in a large urban Canadian population

Nunn J., Erdogan M., & Green R. S. (2016). The prevalence of alcohol-related trauma recidivism: A systematic review.

Poole G. V., Griswold J. A., Thaggard V. K., & Rhodes R. S. (1993). Trauma is a recurrent disease. Surgery, 113, 608–611.

in absence of history of brain trauma.