Study highlights the need for systematic improvements in care for intoxicated minors

Reviewed by Kate Anderton, B.Sc. (Editor)Aug 28 2019

Alcohol and other drug intoxication in minors is a public health challenge. European surveys reveal that schoolchildren start drinking alcohol at an average age of 12, and a third of Spanish 14 to 18 year-olds admit to binge drinking ─ consuming five or more drinks per occasion ─ within the last month. Although alcohol is the most commonly abused substance among minors in Western countries, poly-drug use (often involving cannabis and alcohol) is increasingly common.

A new study has been published in the journal Alcoholism: Clinical & Experimental Research of underage patients with acute recreational alcohol or other drug intoxication who were admitted to a pediatric emergency department (ED) in an urban area of Spain. Review of hospital charts showed a total of 266 admissions (for 258 patients) related to recreational alcohol or other drug intoxication over the 5-year period from 2012 to 2016 ─ averaging one admission per week. Equal numbers of boys and girls were involved, with an average age of 16. Patients were often admitted in the early hours of the morning, with half of the intoxication episodes occuring on a Saturday. Admissions peaked in September and December, and were lowest in January, February and October.

Overall, 84% of admissions were attributed to alcohol only, 9% to cannabis only and 7% to poly-drug use. However, only 28% of patients had undergone urine toxicology screening for illegal drugs, and just 12% had blood tests to assess the level of alcohol exposure. Most cases appeared to be of mild or moderate severity, and almost all patients were discharged on the day of admission. However, the vast majority received no documented counseling or follow-up appointments for alcohol or drug use.

The findings highlight the frequency of admissions for alcohol and drug intoxication among minors at just one pediatric ED, and the infrequent use of toxicology screening tests for illegal drugs and blood ethanol levels. Improved screening for substance exposure would facilitate the early diagnosis of poly-drug abuse and the identification of severe cases of intoxication that require specialized care. The findings also point to a need for systematic improvements in follow-up care whether in the ED or after discharge, to provide an opportunity for counseling and other substance use interventions.