Division of General Pediatrics and Adolescent Medicine, Department of Pediatrics, University of North Carolina at Chapel Hill.
The Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill.
JAMA Netw Open. 2023 Apr 3;6(4):e239549. doi: 10.1001/jamanetworkopen.2023.9549.
Information about the trend in illicit substance ingestions among young children during the pandemic is limited.
To assess immediate and sustained changes in overall illicit substance ingestion rates among children younger than 6 years before and during the COVID-19 pandemic and to examine changes by substance type (amphetamines, benzodiazepines, cannabis, cocaine, ethanol, and opioids) while controlling for differing statewide medicinal and recreational cannabis legalization policies.
DESIGN, SETTING, AND PARTICIPANTS: Retrospective cross-sectional study using an interrupted time series at 46 tertiary care children's hospitals within the Pediatric Health Information System (PHIS). Participants were children younger than 6 years who presented to a PHIS hospital for an illicit substance(s) ingestion between January 1, 2017, and December 31, 2021. Data were analyzed in February 2023.
Absence or presence of the COVID-19 pandemic.
MAIN OUTCOME(S) AND MEASURE(S): The primary outcome was the monthly rate of encounters for illicit substance ingestions among children younger than 6 years defined by International Statistical Classification of Diseases, Tenth Revision, Clinical Modification diagnosis code(s) for poisoning by amphetamines, benzodiazepines, cannabis, cocaine, ethanol, and opioids. The secondary outcomes were the monthly rate of encounters for individual substances.
Among 7659 children presenting with ingestions, the mean (SD) age was 2.2 (1.3) years and 5825 (76.0%) were Medicaid insured/self-pay. There was a 25.6% (95% CI, 13.2%-39.4%) immediate increase in overall ingestions at the onset of the pandemic compared with the prepandemic period, which was attributed to cannabis, opioid, and ethanol ingestions. There was a 1.8% (95% CI, 1.1%-2.4%) sustained monthly relative increase compared with prepandemic trends in overall ingestions which was due to opioids. There was no association between medicinal or recreational cannabis legalization and the rate of cannabis ingestion encounters.
In this study of illicit substance ingestions in young children before and during the COVID-19 pandemic, there was an immediate and sustained increase in illicit substance ingestions during the pandemic. Additional studies are needed to contextualize these findings in the setting of pandemic-related stress and to identify interventions to prevent ingestions in face of such stress, such as improved parental mental health and substance treatment services, accessible childcare, and increased substance storage education.
关于大流行期间幼儿非法物质摄入趋势的信息有限。
评估 COVID-19 大流行前后 6 岁以下儿童整体非法物质摄入率的即时和持续变化，并在控制不同全州药用和娱乐用大麻合法化政策的情况下，检查按物质类型（安非他命、苯二氮䓬类、大麻、可卡因、乙醇和阿片类药物）的变化。
设计、地点和参与者：在儿科健康信息系统 (PHIS) 内的 46 家三级保健儿童医院使用中断时间序列进行的回顾性横断面研究。参与者是在 2017 年 1 月 1 日至 2021 年 12 月 31 日期间因非法物质摄入到 PHIS 医院就诊的 6 岁以下儿童。数据于 2023 年 2 月进行分析。
有无 COVID-19 大流行。
主要结果是通过国际疾病分类，第十次修订，临床修正诊断代码（阿片类药物、苯二氮䓬类药物、大麻、可卡因、乙醇和安非他命中毒）定义的 6 岁以下儿童非法物质摄入的每月发生率。次要结果是个别物质的每月发生率。
在 7659 名因摄入而就诊的儿童中，平均（SD）年龄为 2.2（1.3）岁，5825 名（76.0%）为医疗补助保险/自付。与大流行前相比，大流行开始时整体摄入增加了 25.6%（95%CI，13.2%-39.4%），这归因于大麻、阿片类药物和乙醇摄入。与大流行前的趋势相比，整体摄入的每月相对增长率为 1.8%（95%CI，1.1%-2.4%），这归因于阿片类药物。药用或娱乐用大麻合法化与大麻摄入事件率之间没有关联。
在这项 COVID-19 大流行前后对幼儿非法物质摄入的研究中，大流行期间非法物质摄入出现了即时和持续的增加。需要进一步的研究来了解在大流行相关压力下这些发现的背景，并确定预防这种压力下摄入的干预措施，例如改善父母的心理健康和物质治疗服务、提供可及的儿童保育以及增加物质储存教育。
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