Article
Alcohol, drugs, and urban violence in a small city trauma center

https://doi.org/10.1016/0740-5472(94)00086-7Get rights and content

Abstract

Substance abuse and urban trauma go hand in hand. But research focuses on large cities served by major academic medical centers. Do small cities face the same problems? Two hundred thirty-three urban trauma inpatients from a metro area of 250,000 were studied using patient interviews and medical records. As in large cities, one half used alcohol or drugs when attacked. Seventy percent were likely to be young, male, poor African-Americans. Only 3% were gang members, but demographic characteristics failed to explain substance abuse as they have for larger cities. A culture of violence pervades the small city, as it does in large urban ghettos. Two fifths were repeat urban trauma victims. Two fifths witnessed assaults in the past year. One third carried a knife or gun. Fifteen percent used a weapon on another person in the last year. Contextual variables, like being hurt in a bar, were related to drinking and drugs. The best predictor of present substance abuse and urban trauma was medical history of substance abuse. The need for (a) toxicology screens for all trauma victims, (b) referrals to substance abuse programs, (c) targeting atrisk populations for prevention, and (d) eliminating environments fostering violence and substance abuse is supported.

Keywords

alcohol
drugs
urban trauma
violence

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Research reported here was funded by the Medical Research Fund of St. Elizabeth Hospital Medical Center, Youngstown, Ohio.

1

The authors thank the Medical Research Committee of St. Elizabeth Hospital Medical Center for funding our study, Walter Maksimoff for expertly processing our data, and Barbara Royko for typing the manuscript.

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