Alcohol and Substance Use Among the Working Age Population: A Nationwide Study of Fall-Related Emergency Department Visits.

OBJECTIVES:Prior studies have linked fall-related emergency department (ED) visits among older adults to alcohol use. Characteristics related to falls in the working age population (WAP) (15-64 years) may vary with alcohol and substance use. This study aimed to identify factors associated with fall-related ED visits related to alcohol and substance use in the WAP. METHODS:Using nationally representative 2019-2020 National Hospital Ambulatory Medical Care Survey data, fall-related ED visits within 72 hours were stratified by indication of alcohol use, substance use, and concurrent alcohol and substance use. Descriptive statistics accounting for the survey's complex design were used along with multivariable logistic regression to identify associated factors. RESULTS:Between 2019 and 2020, an estimated 10,800,000 fall-related ED visits occurred among the WAP, with 51.7% related to alcohol use, substance use, or both. Multivariable logistic regression analysis revealed that the WAP with fall injury ED visits were associated with alcohol use (adjusted odds ratio [AOR]: 2.3, 95% confidence interval [CI]:1.0-5.9), concurrent alcohol and substance use (AOR: 8.5, 95% CI: 1.6-43.0) and individuals with alcohol- and substance-use with a depression diagnosis are twice as likely to visit EDs with fall injury. CONCLUSION:Individuals with alcohol- and substance-use with depression were twice as likely to visit EDs for fall injuries. Higher fall-related ED visits in the WAP were attributed to alcohol and substance use. Identified factors could improve injury prevention and timely intervention among the WAP in the United States.