Understanding the Service Needs of Assault-injured, Drug-using Youth presenting for Care in an Urban Emergency Department
Published Date:Sep 28 2014
Source:Addict Behav. 2014; 41:97-105.
Emergency Service, Hospital
Health Services Needs And Demand
Stress Disorders, Post-Traumatic
Pubmed Central ID:PMC4324457
Funding:1R01DA024646/DA/NIDA NIH HHS/United States
K23 MH095866/MH/NIMH NIH HHS/United States
R01 DA020075/DA/NIDA NIH HHS/United States
R01 DA024646/DA/NIDA NIH HHS/United States
R49CE002099/CE/NCIPC CDC HHS/United States
U01CE001957/CE/NCIPC CDC HHS/United States
Violence is a leading cause of injury among youth 15–24 years and is frequently associated with drug use. To inform optimal violence interventions, it is critical to understand the baseline characteristics and intent to retaliate of drug-using, assault-injured (AI) youth in the Emergency Department (ED) setting, where care for violent injury commonly occurs.
At an urban ED, AI youth ages 14–24 endorsing any past six-month substance use (n=350), and a proportionally-sampled substance-using comparison group (CG) presenting for non-assault-related care (n=250), were recruited and completed a baseline assessment (82% participation). Medical chart review was also conducted. Conditional logistic regression was performed to examine correlates associated with AI.
Over half (57%) of all youth met criteria for drug and/or alcohol use disorder, with only 9% receiving prior treatment. Among the AI group, 1 in 4 intended to retaliate, of which 49% had firearm access. From bivariate analyses, AI youth had poorer mental health, greater substance use, and were more likely to report prior ED visits for assault or psychiatric evaluation. Based on multivariable modeling, AI youth had greater odds of being on probation/parole (AOR=2.26; CI=1.28, 3.90) and having PTSD (AOR=1.88; CI=1.01, 3.50) than the CG.
AI youth may have unmet needs for substance use and mental health treatment, including PTSD. These characteristics along with the risk of retaliation, increased ED service utilization, low utilization of other health care venues, and firearm access highlight the need for interventions that initiate at the time of ED visit.
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