Unregulated self-medication in an ambulatory surgery population.

The objective of this study was to determine whether unregulated self-medication in an ambulatory surgery population was a significant problem in terms of the incidence and nature of drugs detected. We asked 67 consecutive patients who presented for elective ambulatory surgery at a university medical center to volunteer for serum and urine testing with the assurance of confidentiality. All patients denied nonprescription drug use. Initial testing was for amphetamines, barbiturates, benzodiazepines, cocaine, opiates, phencyclidine (PCP), tetrahydrocannabinol (THC) and alcohol. Of the 64 patients who agreed to be tested, 16 patients tested positive for at least one of the above substances; 4 patients demonstrated residua of 2 or 3 substances. No distinctive characteristic of those with evidence of drug use could be identified. We believe that the 25% of patients who tested positive in this group is a conservative estimate of possible unrecognized drug use. We have demonstrated a significant incidence of substance abuse in the ambulatory surgery environment. These findings have serious safety implications, and a higher awareness of possible nonprescription drug use in this environment is needed in medical and support personnel.