UMEM Educational Pearls

Title: Pediatric Substance Abuse

Keywords: overdose, precription drugs, pediatric, substance abuse (PubMed Search)

Posted: 4/1/2009 by Dan Lemkin, MS, MD (Updated: 5/24/2009)
Click here to contact Dan Lemkin, MS, MD

Classical illicit recreational drugs like cocaine, ecstacy, and marajuana are sometimes difficult for teens to acquire. As a result, many are turning to their parents medicine cabinets as a source for recreational drugs.

[From the website drugabuse.gov] In 2008, 15.4 percent of 12th-graders reported using a prescription drug nonmedically within the past year. This category includes:

amphetamines
sedatives/barbiturates
tranquilizers
opiates other than heroin
- hydrocodone, oxycodone

When adolescent patient presents to the ED, consider the possibility of a poly-pharmacy overdose. Always query parents about the presence of OTC and Rx medications in their home, and what is within reach of their kids.

While sedatives and analgesics are concerning, be alert for overdoses of more mundane medications like beta blockers and calcium-channel blockers which often pose a much more lethal threat. Consider overdose in adolescent patients with:

GI or respiratory complaints
Altered mental status (combative or somnolent)
Abnormal vital signs
History of depression or psychiatric illness

Monitoring the Future Study: Trends in Prevalence of Various Drugs for 8th-Graders, 10th-Graders, and 12th-Graders

2005-2008 (in percent)*

Any Illicit Drug Use
	8th-Graders				10th-Graders				12th-Graders
	2005	2006	2007	2008	2005	2006	2007	2008	2005	2006	2007	2008
Lifetime Past Year Past Month	21.4 15.5 8.5	20.9 14.8 8.1	[19.0] [13.2] 7.4	19.6 14.1 7.6	38.2 29.8 17.3	36.1 28.7 16.8	35.6 28.1 16.9	34.1 26.9 15.8	50.4 38.4 23.1	48.2 36.5 21.5	46.8 35.9 21.9	47.4 36.6 22.3

Full chart available by clicking link in references.

References

http://www.drugabuse.gov/infofacts/HSYouthTrends.html