Substance use screening and naloxone prescribing at discharge among injured adolescents.

BACKGROUND

Adolescent substance use is closely linked to traumatic injuries. Screening can identify at-risk youth, while naloxone prescribing can reduce fatal overdose. This study examined drug screening and naloxone prescribing among injured adolescents.

METHODS

This single-center retrospective cohort study included injured adolescents 12-17y treated January 2021-June 2024. Sociodemographics, clinical factors, and substance use screening associated with naloxone prescribing were analyzed.

RESULTS

Among 813 injured adolescents, 86 (10.6%) underwent biochemical drug screening and 530 (65.2%) underwent interview-based screening. Among those screened, 53 (61.2%) biochemical and 81 (15.3%) interview screenings were positive. Only 28 (3.4%) received naloxone, including three (5.7%) with positive biochemical and four (4.9%) with positive interview-based screens. Adolescents with interview-based screening (p = 0.006) and hospital stays >24 h (p < 0.001) were more likely to receive naloxone. Most (96.4%) naloxone prescriptions were co-prescribed with opioids and muscle relaxants, instead of substance use screening results.

CONCLUSION

Naloxone prescribing for injured adolescents remains infrequent and unrelated to substance use screening results.