We sought to define the prevalence of positive drug screens in adolesc
ent victims of major trauma. The records of 125 consecutive adolescent
patients presenting with major trauma to an inner-city trauma center
during the last nine months of 1990 were reviewed, Eighty-five (68%) r
eceived urine toxicology screens for alcohol and illicit drugs, Twenty
-one (25%) of screened patients had a positive urine drug screen, The
most commonly detected drugs were alcohol, cocaine, and opiates, Gende
r, race, mechanism of injury, mental status at presentation, injury se
verity score, and revised trauma score were not associated with a posi
tive drug screen, We conclude that: 1) 25% of screened adolescent vict
ims of major trauma seen at an inner-city trauma center had positive u
rine toxicology screens for alcohol or illicit drugs, 2) As none of th
e study variables was associated with a positive drug screen, selectiv
e drug screening cannot be supported.