Alcohol-Only and Drug/Medication-Only Product-Associated Facial Injury Encounters Across COVID-19 Periods: A Public CPSC NEISS Study, 2019–2023

Previous analyses of substance-involved craniofacial trauma have often combined alcohol and drug/medication involvement. We conducted a cross-sectional analysis comparing alcohol-only and drug/medication-only facial injury encounters in the public Consumer Product Safety Commission National Electronic Injury Surveillance System (NEISS), 2019–2023. Primary facial injuries (Body_Part = 76) were classified using the released Alcohol_Involved and Drug_Involved fields. Survey-weighted estimates and Taylor-linearized 95% confidence intervals incorporated the released PSU, stratum, and weight variables; design-based logistic regression evaluated code-4 hospitalization. Among 146,857 observed facial injury encounters, 4117 were alcohol-only and 2302 were drug/medication-only. Weighted annual alcohol-only proportions were stable (trend odds ratio [OR] per year, 0.99; 95% CI, 0.96–1.03; p = 0.716), whereas drug/medication-only proportions increased (OR, 1.15; 95% CI, 1.04–1.27; p = 0.009). Compared with alcohol-only encounters, drug/medication-only encounters involved older patients (weighted mean age, 63.1 vs. 47.6 years) and a lower weighted male proportion (55.6% vs. 67.5%). Weighted code-4 hospitalization was 23.1% versus 11.8%; the adjusted OR was 1.91 (95% CI, 1.45–2.53; p < 0.001). Adult-only and alternative-period sensitivity analyses supported the main conclusions. Separate classification of alcohol and drug/medication involvement revealed distinct demographic, temporal, and disposition patterns among NEISS-captured product-associated ED encounters.