Association of Substance Use with Types of Assault-Related Injury Among Black Men in Baltimore, Maryland

Background: Black men in Baltimore, Maryland experience high rates of assault-related injuries, and the association between substance use and assault-related injury is unclear. The purpose of this study is to examine substance use in association with types of assault-related injury (blunt force, stabbing, and firearm). Methods: Black men aged 18–34 admitted to a large trauma center in Baltimore, Maryland with an assault-related injury and toxicology screen between 2013 and 2017 (N = 1922) were included. We conducted multinomial logistic regression analyses to investigate associations between recent substance use, comorbid diagnoses, and types of assault-related injury. Results: Cannabis was more frequently detected (42.5%), followed by alcohol (24.4%), opioids (22.3%), and cocaine (3.6%). Over one quarter of men screened positive for multiple substances (25.8%). Men who screened positive for alcohol use were 134% more likely to have been stabbed vs. shot and 54% more likely to have been beaten (i.e., blunt force assault) vs. shot. Men who screened positive for cannabis had a 32% lower risk of experiencing a stabbing compared to firearm assault, and 50% lower risk of experiencing a blunt force compared to firearm assault. Conclusion: Among Black men who received care for an assault-related injury, those who were shot were more likely to have screened positive for cannabis and less likely to have screened positive for alcohol. Socio-contextual factors and acute intoxication effects may explain why differing substance types were associated with different types of assault injury. Future research should examine environmental and social contexts of substance use types among assault-injured men.