Экстренная медицина: открытый доступ
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Unsuspected Exposure to Drugs of Abuse in Children

Manzano C, Torres F, Roman L, Hernández M, Villalbí A, Civit E and Oscar Garcia-Algar

Background: In the last decade, the consumption of drugs of abuse has been steady for most of substances, with a significant increase in the consumption of cannabis and cocaine. The aim of the study was to investigate the prevalence of unsuspected exposure to drugs of abuse (cocaine, cannabis, amphetamines, opiates, MDMA) in children attending to an urban paediatric emergency department without signs or symptoms suggestive of exposure. Methods: Hair samples were collected from children between 10 and 14 years of age attending the Paediatric Emergency Department of Hospital del Mar in Barcelona during months of January to April 2014. Intervention was developed based on a brief advice and motivational interview for children. We analyzed the presence of drugs of abuse in hair samples by validated methodologies in liquid chromatography-mass spectrometry. Data were compared to previous studies in the same scenario. Results: From 114 hair samples we obtain 15 positive results (13.5%) for any drugs of abuse, 5 positive results (4.38%) for cocaine (concentration range 0.8-3.97 ng/mg of hair), and 8 positive results for cannabis (7%) (Concentration range 0.10-1.11 ng/mg of hair), 1 positive result for MDMA (0.8%) (0.66 ng/mg of hair) and 1 positive result for amphetamines (0.8%) (1.10 ng/mg of hair). Conclusions: The most important result of this investigation is the maintained and unsuspected high prevalence of paediatric exposure to drugs of abuse in children from low socioeconomic environment in a Mediterranean city during more than a decade. These figures justify the implementation of bio analytical screening protocols; follow up schedules, and preventive strategies. In order to prevent the exposure and consumption of drugs of abuse in children, we recommend interventions of public health and social services to raise consumer awareness of the risks occurring to children, and to push for avoiding consumption in places where adults interact with children.