In a recent study of a cohort of intracerebral hemorrhage (ICH) patients, researchers found disparities in drugs of abuse (DOA) screening and suboptimal guideline adherence. Therefore, systematic efforts to improve screening for DOA are warranted. Researchers identified cases of primary ICH occurring from 2009 to 2011 at academic centers. Demographic data, imaging characteristics, processes of care, and short-term outcomes were ascertained. 610 patients with primary ICH were identified; 379 (62.1%) were initially evaluated at an outside hospital. They found:

• Overall, 142/610 (23.3%) patients were screened, with 21 positive for cocaine and 3 for amphetamine.
• Of patients <55 years, only 65/140 (46.4%) were screened.
• Black patients <55 years were screened more than non-black patients <55 years (38/61 [62.3%] vs 27/79 [34.2%]).
• In the best multivariable model, age group, black race, first Glasgow Coma Scale score, current smoking, and age group × black race were associated with screening.