Controlled Substance Use in Plastic Surgery Related Emergency Department Visits: An NEISS Study of Burn, Hand, and Face Injuries

Purpose: Psychoactive substance use is often a complicating factor in injury that requires an emergency room visit. The present study examined data recorded in the National Electronic Injury Surveillance System (NEISS) database for patients who presented to an Emergency Department (ED) and had psychoactive substance involvement, requiring management by plastic surgery. Methods: A retrospective cohort study was performed using the NEISS database, from 2019 to 2021. Data from patients aged 0 to 102 who suffered burns (46, 47, 48, 49, 51, and 73), face injuries (76), hand injuries (34, 82, and 92), and had psychoactive substance use were queried. Data regarding the specific substances involved were collected. Analysis was performed using SAS to compare the incidence of various substances and the differences in admission status with psychoactive substance use. Results: According to the NEISS estimates, in the United States, 597,916 patients visited the ED for burns, 3,671,677 for facial injuries, and 6,230,087 for hand injuries from January 2019 to December 2021. Across this population, psychoactive substance use was noted in 5605 patients with burn (0.9%), 31,198 with facial (0.8%), and 26,174 with hand (0.4%) injuries. Across all 3 injury types, the total rate of admission was 20% in the substance-use population, and 5% in the nonsubstance-use population. Conclusions: For injuries presenting to the ED that require plastic surgery management, patients with documented psychoactive substance use have higher rates of admission. Given these higher rates of admission, it is important for providers to be aware of differences in the incidences of various substances and the potential for withdrawal.