Lyon-Hospitalizations for drug poisoning in children continue their decrease observed before the Pandemic of Covid-19, after a slight increase during the period of containment. On the other hand, those related to cocaine poisoning continue their progress. Those linked to cannabis stabilize. Comments from the main author of this data, the Pre Florence KaguelidouPediatrician and clinical pharmacologist (Robert Debré University Hospital, Paris, and Center for Clinical Investigations, Inserm CIC1426), during the Congress of the French Pediatric Society[1].
Children from 6 months to 9 years old
New French results on hospitalizations for accidental poisoning in children, whether prescribed drugs, opioids (prescribed or illicit) or illicit/narcotic substances (cannabis, cocaine), come from a transversal study based on medico-administrative data of the Information Systems (PMSI). The hospitalizations for accidental drugs, opioids and narcotics in children aged 6 to 9 in France were collected. This during three periods: prepaandemic (January 2016 – March 2020), confinement (April 2020 -Jun 2021); Lifting measures (July 2021- December 2024). The quarterly hospitalization rates for 100,000 children have been modeled.
More than 80 % of accidental poisoning linked to prescribed drugs
A total of 23,885 hospitalizations for accidental poisoning were identified. 81.2 % were linked to prescribed drugs, 6.6 % to opioids and 16.2 % to narcotics (cannabis, cocaine, other substances) [1].
The Pre Florentia Kaguelidou explains: “In other countries than France, several publications have reported an increase in accidental drug poisoning in children, especially in those under 10 and especially the first two years of life, with an acceleration after the Pandemic of Cavid-19. Domestic products are also documented in several studies. The advanced hypothesis of this study is that confinement, telework and prolonged time spent at home have potentially modified parental behavior and increased children’s exposure to these products. This contextual factor could explain, at least in part, the increase in cases observed during this period. »»
Children are the collateral victims of the evolution of trends in terms of availability, consumption and purity of cocaine.
Hospitalizations for drug poisoning has been declining since 2016
In France, accidental drug poisoning in prescribed drugs have been decreasing since 2016. “This trend probably reflects increased attention from parents with regard to young children’s access to drugs even if this remains to be monitored, Profe Kaguelidou advances. During the containment period, a slight increase was observed, greater than the projections established from previous trends, but it remains moderate, estimated at 7 % beyond the expected rates. »»
With regard to opioids, a decrease in the number of hospitalizations for accidental poisoning was noted during confinement, followed by an even more marked drop when leaving confinement in 2021. “However, a resumption of the upward hospitalizations seems to be taking shape, she points out, and even in 2024, the rates slightly exceed those expected according to the previous trends. This evolution deserves to continue careful monitoring. »»
The drop in the number of opioid poisoning observed during and after confinement could be explained by a decrease in prescriptions in adults. Several publications have indeed mentioned, around the pandemic, a broader questioning of the use of opioids, with a general decline in their prescription, in particular for strong analgesics. Nevertheless, after July 2021, hospitalization trends for accidental poisoning for opioids increased with an increase of 4.9 % per quarter.
Accidental cocaine poisoning in children have significantly increased
Cannabis poisoning hospitalizations stagnate
In France, concerning hospitalizations for accidental cannabis poisoning in children, they almost doubled between 2016 and 2024 going from 0.61 to 1.3 hospitalizations per quarter per 100,000 children. Even if these events remain rare, this progression is clear. Before the pandemic, the trend was particularly marked, with an increase of around 3 % per quarter.
Previous French data published in 2021 had already shown a significant increase in the number of cases of pediatric exposure to cannabis and an increase in the severity of poisoning between 2010 and 2017 [2].
But since confinement, this dynamic has clearly reduced: the increase observed after 2020 is lower (+ 0.8 %, then – 0.5 %), non -statistically significant variations [1]. In other words, given the strong growth recorded before the pandemic, the current trajectory is lower than what the previous data allowed.
+ 26 % hospitalizations for cocaine poisoning in post-Cavid-19
For their part, accidental poisoning to cocaine in children left more beautiful after the pandemic. “It should be remembered that, even before the COVID-19, we already observed in France an upward trend in poisoning with illicit products among young children,” emphasizes the specialist. Certain publications have described serious cases requiring resuscitation management, in particular after exposure to cannabis or cocaine. Besides, before the pandemic, cocaine poisoning had a significant increase, estimated at + 3.3 % per quarter.
Hospitalisation trends for accidental cocaine poisoning increased by 5 % per quarter during confinement and 4.1 % per quarter after raising containment measures.
“Accidental cocaine poisoning in children have significantly increased,” comments Florentia Kaguelidou. There is an increase in the number of hospitalizations compared to the expected number of 15 % during containment, then 30 % from 2021. This dynamic suggests a clear increase in cocaine consumption by adults in the environment of young children. »»
Our results show a decrease in accidental poisoning related to drugs prescribed in children in France
Another study (2023) had looked at the evolution of French pediatric admissions (among those under 15) for poisoning/exposure to cocaine over a period of 11 years (2010-2020)[3]. It had identified an increasing frequency of admission of children intoxicated to pediatric emergencies as well as serious cases. Children are the collateral victims of the evolution of trends in terms of availability, consumption and purity of cocaine.
“Our results show a decrease in accidental poisoning related to drugs prescribed in children in France. It is an encouraging signal, to monitor, underlines Pre Kaguelidou. On the other hand, exposures to opioids and illicit substances are increasing. For cannabis, the increase remains moderate compared to the trends observed before the pandemic, but it continues. Regarding cocaine, the progression is clear and continuous, with levels much higher than those expected. The resumption of poisoning after the pandemic, in particular for opioids and cocaine, underlines the need to strengthen prevention actions with parents and the environment of the child. If there was no death during our study period, a certain percentage of children are nevertheless hospitalized in resuscitation. »»
On this point, in the study mentioned above [2]26.1 % of children intoxicated with cannabis (n = 252) presented a severity score of intoxications of 2 (PSS score), 4.5 % a coma, 4.6 % respiratory depression and 11.7 % were admitted to pediatric intensive care (out of 819 hospitalizations).
Note: hospital data does not always make it possible to distinguish with precision the origin of the analgesic substance (prescription or diverted use).
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