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Chapter 4 - Substance Use
- By David A. Leon, Arvin K. Jundoria, Andrew Stolbach
Edited by Mark Curato, Weill Cornell Medicine, New York, Kaushal Shah, Weill Cornell Medicine, New York, Christopher Reisig, Weill Cornell Medicine, New York
Book:

Urban Emergency Medicine

Published online:

20 July 2023

Print publication:

03 August 2023, pp 39-55
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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.