Occult drug exposure in young children evaluated for physical abuse: An opportunity for intervention. Child Abuse Negl 2019 Feb;88:412-419
Date
01/04/2019Pubmed ID
30605795DOI
10.1016/j.chiabu.2018.12.015Scopus ID
2-s2.0-85059237949 (requires institutional sign-in at Scopus site) 15 CitationsAbstract
BACKGROUND: Although screening for drug exposure is an important consideration in the evaluation of suspected child maltreatment, limited data are available on the frequency of drug exposure in children with suspected physical abuse.
OBJECTIVE: To examine occult drug and pharmaceutical exposure in young children with suspected physical abuse.
PARTICIPANTS AND SETTING: Children ages 2 weeks -59 months evaluated for physical abuse by a tertiary referral center Child Protection Team.
METHODS: Cross-sectional study of young children diagnosed with high, intermediate, or low concern for physical abuse and tested for occult drug exposure from 2013-2017. Chart review was performed to determine adherence to recommended testing and drug test results with comparison between groups.
RESULTS: Occult drug exposures were found in 5.1% (CI 3.6-7.8) of 453 children tested: 6.0% (CI 3.6-10.0) of 232 children with high concern for physical abuse, 5.0% (CI 2.7-9.3) of 179 children with intermediate concern, and 0% of 42 children with low concern. As adherence to protocol-based screening improved during the second half of the study, so did the overall rate of detection of occult drug exposures (7.9%, CI 5.2-11.9) in 252 children with intermediate or high concern for physical abuse. Most exposures were to cocaine, although non-prescribed pharmaceutical exposures were also detected.
CONCLUSIONS: Up to 7.9% of young children suspected of being physically abused also had an occult drug exposure. Given the adverse health consequences associated with exposure to a drug-endangered environment, screening for occult drug exposure should be considered in the evaluation of young children with intermediate or high concern for physical abuse.
Author List
Petska HW, Porada K, Nugent M, Simpson P, Sheets LKAuthors
Hillary W. Petska MD Associate Professor in the Pediatrics department at Medical College of WisconsinLynn Sheets MD Professor in the Pediatrics department at Medical College of Wisconsin
Pippa M. Simpson PhD Adjunct Professor in the Pediatrics department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
Child AbuseChild, Preschool
Cross-Sectional Studies
Early Diagnosis
Female
Humans
Infant
Male
Physical Abuse
Substance Abuse Detection
Substance-Related Disorders
