Controlled Substance Use Among Psychiatric Patients in a Rural North Carolina Emergency Department

Authors

Elizabeth Gignac, Campbell University School of Osteopathic Medicine, Southeastern Health, Emergency Services, Department of Medicine, Lumberton, North Carolina.
G Y. Dogbey, Campbell University School of Osteopathic Medicine, Department of Clinical Research and Medical Education, Lillington, North Carolina.
Gregory Capece, Campbell University School of Osteopathic Medicine, Southeastern Health, Department of Graduate Medical Education, Lumberton, North Carolina.
Benjamin McMichael, Campbell University School of Osteopathic Medicine, Southeastern Health, Department of Graduate Medical Education, Lumberton, North Carolina.
Julie Aldrich, Campbell University School of Osteopathic Medicine, Lillington, North Carolina.
Grace D. Brannan, Campbell University School of Osteopathic Medicine, Department of Clinical Research and Medical Education, Lillington, North Carolina.

Document Type

Article

Date of Publication

3-1-2019

Publication Title

The western journal of emergency medicine

First Page

419

Last Page

425

Abstract

INTRODUCTION: Emergency department (ED) visits for mental health and substance use disorders have been on the rise, with substance use disorders frequently coexisting with mental health disorders. This study evaluated substances commonly used/abused by patients presenting to the ED of a rural, regional medical center with subsequent admission for mental health treatment in Robeson County, North Carolina. METHODS: This retrospective, single-center study was approved by the Southeastern Health Institutional Review Board. We reviewed medical records of psychiatric patients presenting to the ED with ultimate admission to the inpatient psychiatric unit between January 1, 2016, and June 30, 2016. Frequencies of controlled substances testing positive on urine drug and alcohol screenings in admitted patients were obtained and analyzed. We also made ethnic and gender comparisons. RESULTS: A total of 477 patients met inclusion criteria. The percentage of patients testing positive were as follows: tetrahydrocannabinol (THC) (40%); cocaine (28.7%); alcohol (15.1%); benzodiazepines (13%); opiates (9.6%); amphetamines (2.9%); barbiturates (2.3%); and methadone (0.8%). A relatively higher proportion of patients tested positive for THC than any other substance (≤.0002). We found statistically significant differences for gender (=.0004) and ethnicity (<.0001) compositions regarding substance use/abuse. CONCLUSION: The majority of admitted psychiatric patients in this study tested positive for at least one controlled substance. The two substances that most often returned positive on the urine drug screen test in our sample were THC (marijuana) and cocaine. These findings may provide insight into concomitant substance abuse and psychiatric disorders, which could instigate public policy development of preventative health initiatives that explore the relationship between controlled substance use/abuse and mental health disorders in rural counties like Robeson County.

DOI

10.5811/westjem.2018.11.40234

Recommended Citation

Gignac, Elizabeth; Dogbey, G Y.; Capece, Gregory; McMichael, Benjamin; Aldrich, Julie; and Brannan, Grace D., "Controlled Substance Use Among Psychiatric Patients in a Rural North Carolina Emergency Department" (2019). Osteopathic Medicine, Jerry M. Wallace School of. 2352.
https://cufind.campbell.edu/medicine_school/2352