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Psychoactive drug use (PDU) is reported in up to 40% of trauma patients and is associated with a higher rate of in-hospital complications. However, little is known about its long-term impact on trauma patients. We aimed to assess the long-term functional, mental, and psychosocial outcomes of PDU in trauma patients 6 to 12 months after injury. Trauma patients with moderate to severe injuries (Injury Severity Score, 9) who had a toxicology screen upon admission to one of three level 1 trauma centers were contacted by phone 6 to 12 month