DEATH STALKS SURVIVORS OF ALCOHOL-RELATED INJURIES.

BALTIMORE (Reuters) - People who test positive for drugs or alcohol after
surviving a serious accident are about twice as likely to die under violent
circumstances a few years later, a study released on Tuesday suggested.

University of Maryland researchers tracked the medical records of about
27,400 patients who were admitted to the R. Adams Cowley Schock Trauma
Center in Baltimore between 1983 and 1995 with moderate to severe injuries.
The typical trauma patient was described as a white male, aged between 20
and 44.

About 11,000, or 40 percent, tested positive for drugs or alcohol upon
admission. Of that group, more than 600 had died by the end of 1997, with
34 percent as a result of a subsequent car crash, fall, gun incident or
some other violent event.

In comparison, injuries claimed the lives of only 15 percent of trauma
patients who had no sign of drug or alcohol involvement upon admission to
the trauma center.

The study in the Journal of Trauma could not say whether the fatal injuries
were related to drugs or alcohol among those who initially tested positive
for substance abuse. But it suggested that trauma centers could reduce
patient deaths by providing drug and alcohol treatment programs.

"The implication is that if there were some sort of intervention begun at
the time of their initial admission to the hospital, these deaths might
have been prevented," said Patricia Dischinger, a University of Maryland
epidemiologist who co-authored the study.

But findings showed that some trauma centers have stopped screening
incoming patients for drugs and alcohol because health insurance programs
can deny payments to patients who test positive.

The research was funded by the Substance Abuse Policy Research Program of
the Robert Wood Johnson Foundation