Screening for methamphetamine and amphetamine use in trauma: a public health opportunity

Introduction: Despite the association of meth/amphetamine use with risk for unintentional injury and interpersonal violence, screening for meth/amphetamine use among injured patients is not required at US trauma centers. Methods: Using data from the American College of Surgeons Trauma Quality Programs dataset, we examined the prevalence of meth/amphetamine positivity on urine drug screen and its association with clinical outcomes at 873 trauma centers. Results: Of 4.5 million adult trauma patients, 1.5 million (33%) received a urine drug screen, of which 11% were positive for meth/amphetamines. Rates of positivity increased from 9% in 2017 to 12% in 2022. Prevalence among those screened varied widely across trauma centers (interquartile range 4%-16%). Patients who screened positive for meth/amphetamine presented with more severe injuries and required longer hospitalizations. Conclusion: Our findings indicate that meth/amphetamine use is common among trauma patients, with a prevalence several times higher than national averages. For this population, improved screening and intervention for meth/amphetamine use disorder at US trauma centers may represent an opportunity to prevent reinjury and improve the health of patients and their communities.