Substance Use among Youth Presenting to the Pediatric Emergency Department.

IF 2.5 4区 医学 Q3 TOXICOLOGY Journal of Medical Toxicology Pub Date : 2024-10-15 DOI:10.1007/s13181-024-01032-x
Madeline H Renny, Jonathan C Berger, Cindy Mei, George T Loo, Jacqueline A Ansah, Alec D Severe, Roland C Merchant
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Abstract

Objective: Our primary objective was to determine the frequency and type of substance use in youth presenting to our pediatric ED (PED). Our secondary objective was to identify characteristics associated with higher-risk substance use.

Methods: We conducted a tablet-based, anonymous, self-administered screening for substance use using a modified version of the Screening to Brief Intervention (S2BI) tool among a convenience sample of 383 patients 12-21 years presenting to an urban, academic PED from February to July 2023. Patients' attitudes toward ED screening and interventions for substance use also were collected. The frequency and type of substance use was analyzed by age group. Ordinal logistic regression was used to identify characteristics associated with higher-risk use (monthly or more substance use) and lower-risk use (past year use), as compared to no past year use.

Results: Among 14-17-year-olds (n = 144), 38% reported substance use in the past year; 25% had higher-risk use. Among 18-21-year-olds (n = 172), 67% reported substance use in the past year; 48% had higher-risk use. Alcohol, cannabis, and tobacco were most commonly used. Substance use was rare for 12-13-year-olds. Compared to youth 14-17 years, youth 18-21 years were more likely to have either higher-risk use (aOR 3.81, 95% CI (2.24-6.47)) or lower-risk use (aOR 2.74 (1.41-5.35)), rather than no use. Compared to Asian patients, Non-Hispanic White patients (aOR 5.23 (1.07-25.66)) and Hispanic patients (aOR 3.18 (1.06-9.58)) were more likely to have higher-risk use than no use. Most patients reported that it was important for youth to be asked about substance use in the ED and to be offered help for substance use.

Conclusion: Youth substance use was common in this urban, academic PED, and many patients reported higher-risk use. These findings support future research to determine the best practices for ED substance use screening and ED-based interventions for youth.

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儿科急诊室就诊青少年的药物使用情况。
目的:我们的首要目标是确定在儿科急诊室(PED)就诊的青少年使用药物的频率和类型。我们的次要目标是确定与高风险药物使用相关的特征:从 2023 年 2 月到 7 月,我们对 383 名 12-21 岁的患者进行了基于平板电脑的匿名自填式药物使用筛查,这些患者都是在城市的一家学术性儿科急诊室就诊的。此外,还收集了患者对急诊科药物使用筛查和干预的态度。按年龄组对使用药物的频率和类型进行了分析。采用顺序逻辑回归法确定与高风险使用(每月或更多次使用药物)和低风险使用(过去一年使用)相关的特征,并与过去一年未使用药物进行比较:在 14-17 岁的青少年(n = 144)中,有 38% 报告在过去一年中使用过药物;25% 有较高风险的使用。在 18 至 21 岁的青少年中(n=172),67% 的人表示在过去一年中使用过药物;48% 的人使用过高风险药物。最常使用的是酒精、大麻和烟草。12-13 岁的青少年很少使用药物。与 14-17 岁的青少年相比,18-21 岁的青少年更有可能高风险使用(aOR 3.81,95% CI (2.24-6.47))或低风险使用(aOR 2.74 (1.41-5.35)),而不是不使用。与亚裔患者相比,非西班牙裔白人患者(aOR 5.23 (1.07-25.66))和西班牙裔患者(aOR 3.18 (1.06-9.58))更倾向于高风险使用而非不使用。大多数患者表示,在急诊室询问青少年药物使用情况并向其提供药物使用帮助非常重要:结论:在这个城市的学术性急诊室中,青少年使用药物的现象很普遍,许多患者表示使用药物的风险较高。这些发现支持未来的研究,以确定急诊室药物使用筛查和急诊室对青少年干预的最佳实践。
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来源期刊
CiteScore
5.40
自引率
10.30%
发文量
46
期刊介绍: Journal of Medical Toxicology (JMT) is a peer-reviewed medical journal dedicated to advances in clinical toxicology, focusing on the diagnosis, management, and prevention of poisoning and other adverse health effects resulting from medications, chemicals, occupational and environmental substances, and biological hazards. As the official journal of the American College of Medical Toxicology (ACMT), JMT is managed by an editorial board of clinicians as well as scientists and thus publishes research that is relevant to medical toxicologists, emergency physicians, critical care specialists, pediatricians, pre-hospital providers, occupational physicians, substance abuse experts, veterinary toxicologists, and policy makers.       JMT articles generate considerable interest in the lay media, with 2016 JMT articles cited by various social media sites, the Boston Globe, and the Washington Post among others.     For questions or comments about the journal, please contact jmtinfo@acmt.net.    For questions or comments about the journal, please contact jmtinfo@acmt.net.
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