Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri;
School of Medicine, University of Missouri-Kansas City, Missouri; and.
Pediatrics. 2021 Jun;147(6). doi: 10.1542/peds.2020-031468. Epub 2021 May 3.
Adolescent substance use is associated with numerous adverse health outcomes. A hospitalization represents an opportunity to identify and address substance use. We sought to describe self-reported and documented substance use among hospitalized adolescents.
We conducted a cross-sectional survey of adolescents aged 14 to 18 years old admitted to two pediatric hospitals between August 2019 and March 2020. Using previously validated questions, we assessed the proportion of adolescents reporting ever, monthly, and weekly use of alcohol, marijuana, tobacco, electronic cigarettes, and other illicit drugs and nonmedical use of prescription medications. We reviewed medical records for substance use documentation.
Among 306 respondents, 57% were older (16-18 years old), 53% were female, and 55% were of non-Hispanic white race and ethnicity. The most frequently reported substances ever used were alcohol (39%), marijuana (33%), and electronic cigarettes (31%); 104 (34%) respondents reported ever use of >1 substance. Compared with younger adolescents, those aged 16 to 18 years were more likely to report ever use of alcohol (29% vs 46%; = .002), marijuana (22% vs 41%; < .001), and ≥2 drugs (26% vs 40%; = .009). A positive substance use history was rarely documented (11% of records reviewed), and concordance between documented and self-reported substance use was also rare.
In this study of hospitalized adolescents, the most commonly reported substances used were alcohol, marijuana, and electronic cigarettes. Positive substance use documentation was rare and often discordant with self-reported substance use. Efforts to improve systematic screening for substance use and interventions for prevention and cessation in hospitalized adolescents are critically needed.
青少年物质使用与许多不良健康后果有关。住院是识别和解决物质使用问题的机会。我们旨在描述住院青少年自我报告和记录的物质使用情况。
我们对 2019 年 8 月至 2020 年 3 月期间在两家儿科医院住院的 14 至 18 岁青少年进行了横断面调查。使用先前验证过的问题，我们评估了报告曾经、每月和每周使用酒精、大麻、烟草、电子烟和其他非法药物以及非医疗用途处方药物的青少年比例。我们审查了医疗记录以获取物质使用记录。
在 306 名受访者中，57%年龄较大（16-18 岁），53%为女性，55%为非西班牙裔白人种族和民族。报告曾经使用过的最常见物质是酒精（39%）、大麻（33%）和电子烟（31%）；104 名（34%）受访者报告曾经使用过>1 种物质。与年龄较小的青少年相比，16 至 18 岁的青少年更有可能报告曾经使用过酒精（29%比 46%； =.002）、大麻（22%比 41%； <.001）和≥2 种药物（26%比 40%； =.009）。很少有记录（11%的记录被审查）正面的物质使用史，并且记录的物质使用与自我报告的物质使用很少一致。
在这项对住院青少年的研究中，最常报告的使用物质是酒精、大麻和电子烟。阳性物质使用记录很少，并且经常与自我报告的物质使用不一致。需要努力改善对住院青少年物质使用的系统筛查以及预防和戒断的干预措施。
