Exploring the Triad: Mental Health, Substance Use, and Injury Occurrences among Young Adults in Lebanon

Abstract

Background: Injuries remain a major public health concern globally, accounting for over 4.3 million annual deaths, with low- and middle- income countries bearing the greatest burden. In Lebanon, injuries account for 3.4% of total deaths. This study investigated the relationship between injuries and two key risk factors, mental distress and substance use disorders, particularly their co-occurrence, among a sample of young adults from Lebanon. Methods: An online survey was conducted among 401 Lebanese adults aged 18–35, recruited via multiple social media platforms. Validated tools were used to assess mental distress (General Health Questionnaire-12) and potential substance use disorders (CAGE for alcohol; Drug Abuse Screening Test-10 for drugs). Data on injury occurrence, types, severity, and contexts were collected using an adaptation of the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP) form. Bivariate analyses and multiple logistic regression models examined associations between injuries and the predictors, adjusting for demographic variables. Results: Approximately 34% of participants reported at least one injury in the past 12 months, with falls (28.3%) and burns (22.9%) as the most common. Mental distress was detected in 66.6% of participants, and 16% exhibited potential substance use disorders (alcohol and/or drug use). Controlling for sociodemographic, severe mental distress was associated with two-fold odds of injury, while potential alcohol use disorder was associated with a 2.5 increase in odds (p < 0.05). Our main finding highlights that the co-occurrence (vs. not) of mental distress and potential substance use disorders (alcohol and/or drug use) was associated with more than triple the odds of injury. Conclusion: Both mental distress and potential substance disorders significantly contribute to injury among young Lebanese adults, particularly when co-occurring. These findings underscore the need for integrated prevention strategies, including routine mental health screening and substance use interventions, as well as strengthened safety policies and public health infrastructure. Future research should employ longitudinal designs to establish causal pathways and refine targeted prevention programs