The role of alcohol in facial
trauma is recognised but we know of no research on the possible contribution made by the use of
illicit drugs in patients with
facial injuries, or the interactions that may occur during anaesthesia. We aimed to find out whether
illegal drugs were identified in the urine of patients with
maxillofacial injuries, what substances were present, and whether patients were willing to disclose use of drugs at the time of injury. Over a 12-month period we prospectively studied consecutive patients with
facial injuries who were referred by accident and emergency (A&E) to the department of oral and
maxillofacial surgery (OMFS) for inpatient assessment and treatment within 24 h of injury. Anonymised data on patients were obtained from questionnaires that were linked to a urine sample provided on admission. Results were obtained using immunoassay and gas chromatography with mass spectrometry. A total of 105 patients with
facial injuries were eligible and 95 (90%) provided a urine sample and completed the questionnaire; 2 samples were of insufficient volume and were discarded before analysis. Twelve patients (13%) admitted using drugs at the time of injury but 44 (47%) samples tested positive for
illegal drugs; fewer showed the presence of alcohol (n=37; 40%). Use of drugs, although often denied, is widespread among patients with
facial injuries. It is important to consider the role that drugs have in patients who present with traumatic
injuries, the interactions misused drugs may have with anaesthesia, and any possible benefits that targeted prevention strategies would have in this group.