Pediatric Ingestion of Illicit Substances Increased by 25.6%

According to a study published in JAMA Network Open, pediatric ingestion rates of illicit substances increased by 25.6% with the onset of the COVID-19 pandemic. Additional insights determined that the increase was sustained throughout the pandemic.

In this retrospective cross-sectional study, researchers focused on pediatric patients younger than six who were seen between January 1, 2017, and December 31, 2021. Data was collected from nearly 50 pediatric tertiary care hospitals in the Pediatric Health Information System (PHIS).

The investigators focused on patients whose visits included an ICD code for poisoning by amphetamines, benzodiazepines, cannabis, cocaine, ethanol, and opioids.

Based on these parameters, the study analyzed data from 7,659 children, with the average age being 2.2 years old. Most of the patients, 76.0%, were Medicaid-insured or self-paid. The rest of the patients were privately insured or had no insurance information.

The overall ingestion rate at the onset of the pandemic increased by 25.6%, with a 1.8% sustained monthly increase. When researchers focused on individual substances, they determined that amphetamine, cocaine, and benzodiazepine ingestions were not affected by the initial onset of the pandemic. In fact, the monthly increase in amphetamine ingestion during the pandemic period dropped to 1.1% from pre-pandemic rates.

Focusing on cannabis ingestion, the researchers noted that cannabis legislation had no significant impact on ingestion rates. There were 23.9 more cannabis ingestions per 10,000 encounters from April 2020 to December 2021, regardless of legislative differences.

The data revealed an immediate 70.7% increase in cannabis ingestion encounters during the pandemic; however, after initial increases, the pre-pandemic 2.2% monthly increase in ingestion persisted during the pandemic period.

Additionally, ethanol ingestion rates increased by 80.8% immediately after the pandemic began. The researchers noted 2.3 more ethanol ingestions per 10,000 encounters from April 2020 to December 2021.

Finally, the study highlighted opioids as a significant driver of pediatric ingestion of illicit substances. With the pandemic onset, opioid ingestion rates increased by 27.5%. Beyond that, there was a sustained monthly increase of 4.9%, causing 12.4 more opioid ingestions per 10,000 encounters throughout the pandemic period.

The data from this study follows similar data from the American Academy of Pediatrics, which reported that opioids are a significant contributor to pediatric overdose deaths. That research found that 24 of the 46 substances linked to pediatric poisoning fatalities were opioids.

Once again, scientific analysis has revealed a need for more opioid education, harm reduction, and risk assessment strategies.

“These findings suggest the need for interventions to address factors that may be associated with the observed increase in illicit substance ingestions. Such interventions may include supporting policies that buffer family stress, improving parent access to and affordability of mental health and substance treatment services, increasing availability of childcare, and providing education about safe storage of substances in the home,” concluded researchers in the JAMA study.