The Association of the Child Opportunity Index with Emergency Department Presentations for Pediatric Poisonings: A Case-Control Study.

Objective: To examine the relationship between the Child Opportunity Index (COI) and unintentional poisonings in a geographically diverse pediatric population.

Study Design: We conducted a retrospective, case-control study of children ≤ 6 years of age who had emergency department encounters for poisonings from January 1, 2016, to December 31, 2021. Data were obtained from the Pediatric Health Information System database.

Welcome to the 2024 ACMT Annual Scientific Meeting.

Two hundred sixteen abstracts were selected for presentation at the 2024 American College of Medical Toxicology (ACMT) Annual Scientific Meeting on April 12-14, 2024, in Washington, DC. The quality and breadth of toxicology scholarship continues to grow as our field expands. The complete 2024 ASM abstract book in the April issue of JMT includes original research studies from around the world and the ToxIC Investigators Consortium, clinically significant case reports describing toxicologic phenomena, and selected encore research presentations from other scientific meetings.

Resource utilization among children presenting with cannabis poisonings in the emergency department.

Background: Exploratory pediatric cannabis poisonings are increasing. The aim of this study is to provide a national assessment of the frequency and trends of diagnostic testing and procedures in the evaluation of pediatric exploratory cannabis poisonings.

Methods: This is a retrospective cross-sectional study of the Pediatric Health Information Systems database involving all cases of cannabis poisoning for children age 0-10 years between 1/2016 and 12/2021.

Pediatric hand sanitizer exposures reported to United States poison centers, 2017-2021.

Introduction: The COVID-19 pandemic increased demand for alcohol-based hand sanitizers. We aimed to describe the epidemiological trends in pediatric alcohol-based hand sanitizer cases reported to United States poison centers. We characterized clinically significant pediatric reports involving alcohol-based hand sanitizer products before and during the pandemic and methanol-containing hand sanitizers during the pandemic.

Association of prescription drug monitoring programs with benzodiazepine prescription dispensation and overdose in adolescents and young adults.

Introduction: Prescription drug monitoring programs are state-run databases designed to support safe prescribing of controlled substances and reduce prescription drug misuse. We analyzed healthcare claims data to determine the association between prescription drug monitoring programs with mandated provider review and adolescent and young adult benzodiazepine prescription dispensing and overdose.

Methods: We performed a state-level retrospective cohort study to evaluate the association between implementation of prescription drug monitoring programs with mandated provider review and benzodiazepine prescription dispensing and benzodiazepine-related overdoses among adolescents (13-18 years) and young adults (19-25 years) between 1 January 2008 and 31 December 2019.

Association of Prescription Drug Monitoring Programs With Opioid Prescribing and Overdose in Adolescents and Young Adults.

Study Objective: Prescription opioid use is associated with substance-related adverse outcomes among adolescents and young adults through a pathway of prescribing, diversion and misuse, and addiction and overdose. Assessing the effect of current prescription drug monitoring programs (PDMPs) on opioid prescribing and overdoses will further inform strategies to reduce opioid-related harms.

Methods: We performed interrupted time series analyses to measure the association between state-level implementation of PDMPs with annual opioid prescribing and opioid-related overdoses in adolescents (13 to 18 years) and young adults (19 to 25 years) between 2008 and 2019.

Pediatric Melatonin Ingestions - United States, 2012-2021.

Melatonin is an endogenous neurohormone that regulates the sleep-wake cycle (1). It is used therapeutically for insomnia in adults and for primary sleep disorders in children (2). Melatonin is regulated by the Food and Drug Administration (FDA) as a dietary supplement.

National assessment of anti-epileptic drug exposures among pre-teens and adolescents, 2000-2020.

Background And Objectives: Anti-epileptic drugs (AEDs) are increasingly used to treat psychiatric conditions, exposing many children to potentially harmful medications. This includes adolescents, who are at higher risk for self-harm. The purpose of this study was to describe the epidemiology of pediatric AED poisonings and assess which AEDs are associated with more severe clinical outcomes.

Trends in Benzodiazepine Prescribing for US Adolescents and Young Adults From 2008 to 2019.

This cohort study examines whether trends exist in the number of benzodiazepines and opioids prescribed to adolescents and young adults between 2008 and 2019.

Commentary on Hill et al.: Breaking down barriers-increasing access to lifesaving opioid use disorder medications to save lives.

Numerous barriers exist for patients attempting to access treatment for opioid-use disorder and/or naloxone, with geographical, racial, and age-related differences exacerbating these hardships.

Clinical Effects of Pediatric Clonidine Exposure: A Retrospective Cohort Study at a Single Tertiary Care Center.

Background: Pediatric clonidine ingestions frequently result in emergency department visits and admission for cardiac monitoring. Detailed information on the clinical course and specifically time of vital sign abnormalities of these patients is lacking.

Objective: The objective of this study was to provide descriptive analysis of the rates and times to vital sign abnormalities, treatment, disposition, and outcomes in a single-center cohort of pediatric patients with report of clonidine poisoning.

Association of State-Level Opioid-Reduction Policies With Pediatric Opioid Poisoning.

Importance: Opioid-reduction policies have been enacted by US states to address the opioid epidemic. Evidence of an association between policy implementation and decreased rates of pediatric opioid poisoning provides further justification for expanded implementation of these policies.

Objective: To examine the association of 3 state-level opioid-reduction policies with the rate of opioid poisoning in children and adolescents.

Prolonged central apnoea after intravenous morphine administration in a 12-year-old male with a UGT1A1 loss-of-function polymorphism.

Adverse Event: Repeated and prolonged episodes of central apnoea and hypoxia after receiving intravenous morphine for analgesia and ketamine for sedation.

Drug Implicated: Intravenous morphine sulfate.

The Patient: Previously healthy 12-year-old male with no history of sleep apnoea who presented with distal tibia and fibula fracture.

Pharmacologic Treatment of Opioid Use Disorder: a Review of Pharmacotherapy, Adjuncts, and Toxicity.

Opioid use disorder continues to be a significant source of morbidity and mortality in the USA and the world. Pharmacologic treatment with methadone and buprenorphine has been shown to be effective at retaining people in treatment programs, decreasing illicit opioid use, decreasing rates of hepatitis B, and reducing all cause and overdose mortality. Unfortunately, barriers exist in accessing these lifesaving medications: users wishing to start buprenorphine therapy require a waivered provider to prescribe the medication, while some states have no methadone clinics.

Myocardial Infarct After Marijuana Inhalation in a 16-year-old Adolescent Boy.

Many reports of marijuana-associated myocardial infarct (MI) are limited by incomplete evaluation of the toxicologic exposure, a lack of definitive anatomic findings, and the potential for comorbid coronary atherosclerosis inherent in an adult population. We report a 16-year-old adolescent boy who presented with chest pain after smoking marijuana and was found to have acute MI. Electrocardiogram showed diffuse ST-segment elevations.

A case report of methadone-associated hypoglycemia in an 11-month-old male.

Background: Methadone is a synthetic μ-opioid receptor agonist that is used in the management of pain, neonatal abstinence withdrawal syndrome, and opioid dependence. Overdose can cause miosis, respiratory depression, and central nervous system depression. Rarely, hypoglycemia has been reported.