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The spectrum of intoxication and poisonings among adolescents: surveillance in an urban population
  1. T L Cheng1,
  2. J L Wright2,3,4,
  3. A S Pearson-Fields5,
  4. R A Brenner6,
  5. the DC Child/Adolescent Injury Research Network*
  1. 1Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, MD, USA
  2. 2Children’s Research Institute, Washington, DC, USA
  3. 3George Washington University School of Medicine and School of Public Health, Washington, DC, USA
  4. 4Department of Emergency Medicine, Children’s National Medical Center, Washington, DC, USA
  5. 5The Mautner Project, Washington, DC, USA
  6. 6National Institutes of Child Health and Human Development, Bethesda, MD, USA
  1. Correspondence to:
 Dr T L Cheng
 Chief, Division of General Pediatrics & Adolescent Medicine, Johns Hopkins University, 600 N Wolfe Street, Park 392, Baltimore, MD 21287, USA


Aim: Among adolescents, poisoning is a leading cause of injury mortality in the United States. This study describes the epidemiology of poisonings, intoxication, and maladaptive effects of drugs among adolescents age 10–19 years in a large city.

Methods: An injury surveillance system used records at seven hospitals, medical examiner records, and vital records over a two year period.

Results: Of 633 cases (618 injuries/100 000/year), 6% were unintentional, 36% self-inflicted, 41% alcohol intoxication, and 15% maladaptive effects of drugs. Alcohol was involved in 45% of cases, 23% illegal drugs, 23% non-prescription drugs, 19% prescription drugs; 19% involved more than one substance. Hospitalization was required in 20%; 8% transferred to another hospital; one died from intoxication. The authors found high rates of self-inflicted poisoning, intoxication, and maladaptive effects of drugs among this urban population.

Conclusion: The study highlights the need to broadly define poisonings among adolescents and the challenge of assessing intent in some cases.

  • poisoning
  • drug abuse
  • substance-related disorders
  • injury
  • epidemiology

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  • * Participants in the DC Child and Adolescent Injury Research Network including: Millicent Collins, MD, DC General Hospital; Melissa Clark, MD, Howard University Hospital; Peter Rhee, MD, Mark Smith, MD, Kristen Brandenburg, Duncan Harviel, MD, Washington Hospital Center; Yolanda Haywood, MD, B Tilman Jolly, MD, George Washington University Medical Center; James Vafier, MD, Diane Sauter, MD, Ira Mehlman, MD, Greater Southeast Community Hospital; Harinder Dhinsa, MD, Renee Reed, MD, David P Milzmann, MD, Georgetown University Hospital; Joseph Pestaner, MD, Jacqueline Lee, MD, Chief Medical Examiner’s Office; Fern Johnson-Clark, PhD, DC Vital Records.

  • Support: This project was supported by the Centers for Disease Control and Prevention (R49/CCR311657-01), DC-Baltimore Research Center on Child Health Disparities Grant Number P20 MD00165 from the National Center on Minority Health and Health Disparities, and the Robert Wood Johnson Foundation Generalist Faculty Scholars Program (Dr Cheng). This work was performed when Dr Cheng and Ms Pearson Fields were at Children’s National Medical Center, Children’s Research Institute, George Washington University School of Medicine and Public Health. This work was presented in a poster at the World Injury Conference, Vienna, Austria, 7 June 2004.

  • Competing interests: none.