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Chapter 4 - Substance Use

Published online by Cambridge University Press:  20 July 2023

By
David A. Leon ,
Arvin K. Jundoria  and
Andrew Stolbach
Edited by
Mark Curato ,
Kaushal Shah  and
Christopher Reisig
Mark Curato
Affiliation:
Weill Cornell Medicine, New York
Kaushal Shah
Affiliation:
Weill Cornell Medicine, New York
Christopher Reisig
Affiliation:
Weill Cornell Medicine, New York
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Summary

It has been estimated that 11% of United States ED patients have substance use disorder. One urban ED estimated that nearly 7% of visits were due to illicit drug use. In a large statewide review of ED visits, alcohol use disorder was more prevalent in rural settings while opioid use disorder was more prevalent in urban settings. Substance use leads to harmful outcomes such as acute injuries, overdose, and medical complications. Forensic laboratory data offers some insight on which drugs are commonly used in US cities. (Ethanol is not included in these reports, but is used ubiquitously and considered to be the most commonly used intoxicating drug.) Opioids, sympathomimetics, cannabinoids, and sedatives classes predominate in all US cities, although there is some regional variation of the specific drugs used among cities. In Baltimore, for example, the top four drugs identified are cocaine, fentanyl, heroin, and tramadol; in Phoenix, the top four are cannabis, fentanyl, heroin, and methamphetamines.

Keywords

OverdoseToxicologyOpioid toxicityopiate toxicityUrine drug screenBody packingBody stuffingPatients in police custody
Type
Chapter
Information
Urban Emergency Medicine , pp. 39 - 55
Publisher: Cambridge University Press
Print publication year: 2023

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