Use of alcohol and illicit drugs by trauma patients in Sao Paulo, Brazil.

INTRODUCTION: Alcohol and illicit drugs impair cognitive and psychomotor skills and may thereby increase the risk of involvement in a road traffic crash and other types of injuries. However, the knowledge on the use of psychoactive substances among injured patients presenting to emergency departments in low and middle-income countries remains limited. AIMS: To estimate the prevalence of alcohol and illicit drug use among patients with traumatic injuries admitted to an emergency department in Sao Paulo, Brazil. METHODS: Blood samples from injured patients requiring hospitalization for more than 24 h due to road traffic crashes, falls, or violence, were collected from July 2018 to June 2019. The samples were analyzed for alcohol and illicit drugs. RESULTS: A total of 376 patients were included in this study; the median age was 36 years and 80% of patients were male. The majority (56%) of injuries resulted from road traffic crashes, with approximately half of them being motorcyclists. Alcohol, drugs, or both were detected in 32% of samples. The proportion that tested positive was highest for males (35%), for the age group 18-39 years (41%), for singles (43%), and for patients injured at nighttime (44%). Patients injured due to violence had the highest prevalence of alcohol or drugs in their blood samples (44%). Alcohol was most prevalent (23%), followed by cocaine (12%) and cannabis (5%). CONCLUSION: The use of alcohol and illicit drugs was common among injured patients in Sao Paulo; it was likely a contributing factor in a third of the injurious accidents. Alcohol was the most prevalent substance followed by cocaine and cannabis.

Comparison of traffic data and blood alcohol concentration among fatally injured drivers in Norway and Sao Paulo, Brazil, 2005-2015.

Objective: Road traffic crashes (RTCs) are responsible for a large number of deaths worldwide, but low- and middle-income countries frequently present higher rates of deaths; for example, Norway, a high-income country, has a rate of 2.0 drivers killed per 100,000 inhabitants, whereas Brazil, a middle-income country, has a rate of 18.4. A significant fraction of RTCs are related to use of psychoactive substances, especially alcohol, due to its availability, legality, and relatively low price. The aim of the present study was to evaluate differences in alcohol-related fatal RTCs in Sao Paulo, the largest city in Brazil, and Norway during an 11-year period (2005-2015). Methods: The authors compared databases of drivers killed in RTCs in Sao Paulo and in Norway, a country renowned for its success in reducing traffic fatalities and keeping them at a low level. Results: In total, 772 victims from Norway (11 years, 2005 to 2015) and 584 victims from Sao Paulo (2 years, 2005 and 2015) were analyzed. Sao Paulo presented higher proportions of motorcycle drivers, men involved in RTCs, and blood alcohol concentration (BAC)-positive cases. The mean BAC for alcohol-positive cases was similar in both sites. For both regions, the percentage of alcohol-positive cases decreased during the study period (from 45.6% to 35.3% in Sao Paulo and from 24.4% to 15.8% in Norway) but remained higher for Sao Paulo. Conclusions: The study shows a different profile of RTC victims and higher alcohol consumption among drivers in Sao Paulo. The differences between the sites can possibly be attributed to public policies regarding traffic safety and alcohol control, which could be further improved by following the Norwegian model in Sao Paulo.