Presentations of active substance use in the emergency department: A single center’s perspective study in Riyadh, Saudi Arabia


Objectives:

To explore the most common clinical presentations of active substance users in our institution’s Emergency Department (ED).


Methods:

This was a retrospective chart review of all patients that were brought to the ED of King Saud University Medical City in Riyadh, Saudi Arabia thought to be actively using illicit substances, between January 2019 and December 2021. Those with incomplete data were excluded.


Results:

A total of 582 patients were included in the study, 532 (91.4%) males, the majority were in the age group 21-30 years old (53.1%). Most patients were fully alert (n=405, 69.6%). Overall, cannabis was used by 349 (60%) of patients. Seventy-four patients presented to the ED because of motor vehicle collisions, the majority were males (98.6%), 35 (47.3%) were the driver of the vehicle and 40 (54.1%) were on cannabis. Males had 5.5 times more medical illness presentations and 10.8 times traumatic illness presentations when compared to females predominantly presenting with psychological illness presentations.


Conclusion:

Among Saudi users of illicit substances, the majority were young men with medical illness presentations. The rate of traumatic injuries / vehicular and road traffic accidents is at 15.3%, and cannabis and amphetamine were the most used substances. Screening for active substance use should be conducted using both patient histories and laboratory testing for all high-risk presentations and not solely based on clinical assessment.


Keywords:

Saudi Arabia; clinical presentation; drugs of abuse; emergency department; illicit substances.

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