UMEM Educational Pearls

Title: Substance use associated with fall injuries

Category: Trauma

Keywords: substance use, falls, older, injury (PubMed Search)

Posted: 2/4/2026 by Robert Flint, MD (Updated: 2/19/2026)
Click here to contact Robert Flint, MD

In a single level 1 trauma center there were 274 patients age over 55 evaluated for falls in a one year retrospective period.  Their blood toxicology was reviewed for presence of alcohol, opioids, benzodiazepines and cannabinoids. The authors found:

“detection rates were 21.2% for opioids, 18.6% for ethanol, 13.9% for benzodiazepines, and 9.1% for cannabinoids. Injuries identified included 16.4% spinal fractures, 9.5% extremity fractures, 7.7% hip/thigh/pelvic fractures…In this study, nearly 20% of adults 55+ presenting for fall-related trauma recently used substances that impair psychomotor function.”

An area for injury prevention research and intervention would be to screen patients over age 55 for substance use, consider prescribing patterns in this age group (benzodiazepines) , and discuss with patients fall risk avoidance.

References

Relationship of Ethanol, Cannabinoids, Benzodiazepines, and Opioids to Serious Injuries from Falls in Adults Aged 55 and Older

Babu, Kavita M. et al.

Journal of Emergency Medicine, Volume 0, Issue 0