Risk of Injury: The Implications of Mental Health, Alcohol and Gender

Each year, hundreds of thousands of deaths occur due to intentional and unintentional injuries related to alcohol use. Alcohol impairs coordination as well as our ability to perceive and respond to hazardous situations, making it more likely that we will get hurt. Research shows the risk for injury increases as the amount of alcohol use increases. For example, someone consuming five or more drinks on one occasion is 10 times more likely to get injured in the following six hours. But are certain people more likely to get injured when they drink? Are there additional factors associated with alcohol use that could further increase your risk of injury?

In my Master’s thesis, I looked at how alcohol use, mental health symptoms and gender contributed to the risk of injury for British Columbians. I used data from the Alcohol and Other Drugs Monitoring Study, which collects data from people who are admitted to the Emergency department at the Royal Jubilee Hospital in Victoria and Vancouver General Hospital.

I found that the risk for injury increased as the amount of alcohol use increased. The greatest risk of injury is for men, and those consuming six or more drinks in the six-hour period prior to the injury event. I also found that mental health symptoms such as anxiety or depression exacerbated the effect of alcohol and the likelihood of injury among women. Women who consumed alcohol and had mental health symptoms were almost twice as likely to be injured compared to women without mental health symptoms.

Why would the presence of mental health symptoms place women at a greater risk for experiencing injury from alcohol use? It could be that women experiencing mental health issues are more likely to drink as a form of self-medication; however, it is difficult to determine the direction of this effect, as long-term alcohol use has been known to lead to the development of depression and anxiety. Another possible explanation is that because women with mental health symptoms are more likely to take medication to treat the symptoms, the alcohol may be interacting with the medication and resulting in detrimental effects. Finally, higher levels of impulsivity are found among individuals experiencing depression, and it may be that the combination of impulsivity and alcohol use could result in someone engaging in more risk-taking behaviors, thereby placing them at a greater risk of injury.

How can we use this information to help prevent future injuries? It is important that health care providers are aware of the combined effect of mental health symptoms and alcohol on risk of injury. If individuals presenting injuries at the emergency departments could be quickly screened for mental health symptoms such as anxiety and depression, the treatment of these symptoms could potentially result in a reduction of risky alcohol use and help to prevent future injuries. For future research, we hope to continue to look at the inter-relationships between these three factors on risk of injury. In particular, we want to look at whether the risk may differ when comparing violent to non-violent related injuries.

audra roemer

Author: Audra Roemer, Centre for Addictions Research of BC

Audra Roemer completed her Masters Degree in Clinical Psychology at the University of Victoria in July 2014 and will be starting her PhD in September 2014. She studied at the University of British Columbia for her Bachelors degree; her research interests include: substance use, family and individual risk factors, gender, prevention, violence and injury, and child and adolescent development.

**Please note that the material presented here does not necessarily imply endorsement or agreement by individuals at the Centre for Addictions Research of BC.