Two hundred eleven adult emergency hand patients were prospectively tested over a 1-year period for drug and alcohol use. On admission, blood and urine samples were sent for quantitative alcohol and qualitative toxicology screens, respectively. In 44% of all patients tests were positive for one or more drugs or alcohol. Tests were positive in 43% of those with traumatic injuries. Of patients injured on the job, 33% had positive tests. Tests were positive in 63% of those patients with hand infections. One third of the patients with positive toxicology screens were multiple drug users. These findings have obvious implications for the patient, the physician, and society as a whole.
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