Five-Year Incidence of Hospital-Based Emergencies Related to Acute Recreational Intoxication in Minors

Alcohol Clin Exp Res. 2019 Oct;43(10):2179-2186. doi: 10.1111/acer.14166. Epub 2019 Aug 27.

Abstract

Background: Alcohol or other drug (AOD) intoxication in minors is a public health challenge. We characterized underage patients admitted to an emergency department (ED) with acute, recreational AOD intoxication.

Methods: We conducted a 5-year (2012 to 2016) analysis of minors admitted to the only hospital-based pediatric ED in an urban area. Episodes of AOD intoxication were selected using ICD-9-CM diagnostic codes. Sociodemographics, substance use and clinical characteristics, laboratory parameters, and discharge dispositions were collected through the revision of clinical charts.

Results: A total of 266 admissions related to recreational AOD intoxication in 258 patients occurred during the study period. Among the 258 patients, 127 (49.2%) were men, median age 16 years [IQR: 15 to 17 years], and 234 (90.7%) of episodes were alcohol-related. At admission, 202/256 (78.9%) patients had a Glasgow Coma Scale ≥ 13 points, the median systolic and diastolic blood pressure was 109 mmHg (IQR: 101 to 118 mmHg) and 67 mmHg (IQR: 60 to 73 mmHg), respectively, and the median blood glucose level was 112 mg/dl (IQR: 99 to 127 mg/dl). Only 72/258 (27.9%) patients underwent urine screening (22/72 (30.5%) were positive for cannabis), and only 30/258 (11.6%) were tested for blood ethanol (median: 185 mg/dl, IQR: 163 to 240 mg/dl). There was a trend in admissions occurring early in the morning of weekend days, and 249 (96.5%) patients were discharged home the day of admission.

Conclusions: Though the severity of AOD intoxication seems to be mild to moderate, assessment of substance exposure is low and may underestimate polydrug use in underage populations.

Keywords: Adolescents; Alcohol; Intoxication; Minors; Substance Use.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Alcoholic Intoxication / epidemiology*
  • Alcoholic Intoxication / therapy*
  • Blood Pressure / drug effects
  • Central Nervous System Depressants / blood
  • Emergencies
  • Emergency Medical Services / statistics & numerical data*
  • Ethanol / blood
  • Female
  • Glasgow Coma Scale
  • Humans
  • Incidence
  • Male
  • Marijuana Abuse
  • Minors
  • Patient Discharge / statistics & numerical data
  • Socioeconomic Factors
  • Spain / epidemiology
  • Substance-Related Disorders / complications
  • Substance-Related Disorders / epidemiology

Substances

  • Central Nervous System Depressants
  • Ethanol