Renny Madeline H, Berger Jonathan C, Mei Cindy, Loo George T, Ansah Jacqueline A, Severe Alec D, Merchant Roland C
Department of Emergency Medicine, Icahn School of Medicine at Mount Sinai, 150 East 42nd Street, 9th floor, New York, NY, 10017, USA.
Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
J Med Toxicol. 2025 Jan;21(1):51-59. doi: 10.1007/s13181-024-01032-x. Epub 2024 Oct 15.
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.
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.
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.
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.
我们的主要目标是确定前来我院儿科急诊部（PED）就诊的青少年物质使用的频率和类型。次要目标是识别与高风险物质使用相关的特征。
我们在2023年2月至7月期间，对前来一所城市学术性儿科急诊部就诊的383名12至21岁患者的便利样本，使用改良版的简短干预筛查（S2BI）工具进行了基于平板电脑的匿名自我管理物质使用筛查。还收集了患者对急诊部物质使用筛查和干预的态度。按年龄组分析物质使用的频率和类型。与过去一年未使用物质相比，采用有序逻辑回归来识别与高风险使用（每月或更频繁物质使用）和低风险使用（过去一年使用过）相关的特征。
在14至17岁的青少年（n = 144）中，38%报告在过去一年有物质使用；25%有高风险使用。在18至21岁的青少年（n = 172）中，67%报告在过去一年有物质使用；48%有高风险使用。酒精、大麻和烟草是最常用的物质。12至13岁的青少年物质使用情况很少见。与14至17岁的青少年相比，18至21岁的青少年更有可能有高风险使用（调整后比值比[aOR] 3.81，95%置信区间[CI] [2.24 - 6.47]）或低风险使用（aOR 2.74 [1.41 - 5.35]），而不是没有使用。与亚洲患者相比，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]）比没有使用更有可能有高风险使用。大多数患者报告说，在急诊部询问青少年物质使用情况并为其提供物质使用方面的帮助很重要。
在这个城市学术性儿科急诊部，青少年物质使用情况很常见，许多患者报告有高风险使用。这些发现支持未来开展研究，以确定儿科急诊部物质使用筛查的最佳实践以及针对青少年的基于急诊部的干预措施。
