A French study of cocaine intoxication/exposure in children (2010–2020)

Figures & data

Figure 1. French regional geographic distribution of participating centers (n = 24, one circle corresponds to one center) and their respective cases of cocaine-related pediatric exposures/intoxications (2010–2020).

Graph 1. Distribution of cocaine-related admissions in French pediatric emergency departments compared to data from the French ICD-10 diagnosis base and to data from cocaine exposure-related calls to the French poison control centers during the study period (2010–2020). ICD- 10: International Classification of Diseases, 10th revision.

Table 1. Main characteristics of pediatric patients admitted for cocaine intoxication/exposure between 2010 and 2020 (percentages in column).

Characteristics, n(%)	Total (n = 74)	Age < 6 years (n = 34)	Age ≥ 6 years (n = 40)	P
Number of admissions				0.92
2010–2015	9(12)	4(12)	5(12)
2016–2020	65(88)	30(88)	35(88)
Seasonal distribution				0.13
Summer (June to August)	25(34)	8(24)	17(43)
Spring (March to May)	20(27)	13(38)	7(18)
Autumn (September to November)	18(24)	7(21)	11(28)
Winter (December to February)	11(15)	6(17)	5(11)
Weekly distribution
Weekday	47(64)	22(65)	25(63)
Weekend	27(36)	12(35)	15(27)
Method of admission				0.002
Family	29(39)	19(56)	10(25)
Sanitary (ambulance, firefighters)	21(28)	6(18)	15(37)
Police	11(15)	2(6)	9(22)
Medicalized transport (provided by SAMU-SMUR)	7(9)	6(18)	1(2)
Not specified	6(8)	1(2)	5(12)
Time of admission				0.18
8:00AM–11:00AM	7(9)	2(7)	5(13)
12:00AM–5:00PM	19(26)	10(29)	9(22)
6:00PM–11:00PM	31(42)	11(32)	20(50)
12:00PM–7:00AM	17(23)	11(32)	6(15)
Age group (years)
0–2	25(34)
2–5	7(9)
5–10	3(4)
≥10	39(53)
Mean age, years (SD)	8.04 (6.34) (median 12)
Previous medical history
Known drug users	10(14)
Intrauterine growth retardation	5
Prematurity	3
Neurodevelopment impairment	2
Place of intoxication				<0.0001
Home	30(41)	27(79)	3(8)
Public area, street	17(20)	1(3)	16(40)
Not specified	27(39)	6(18)	21(52)
Intoxication route
Oral	38(51)	21(62)	17(42)
Breast-feeding	4(5)	4(12)	0(0)
Inhalation	3(5)	1(2)	2(5)
Not specified	29(39)	8(24)	21(52)
Initial admission to pediatric resuscitation room	16(22)	11(32)	5(12)	<0.001
Parental consumption (44 answers)
Yes	25(57)
No	19(43)
Social measures
Report of special concern to child protection services	36(49)	27(79)	8(20)	<0.0001
Simple referral to child protection services	23(31)	20(59)	3(7)
Foster care placement	18(24)	17(50)	1(2)
Complaint to the police department	6(8)	2(4)	4(10)
None	2(3)	2(4)	0(0)
Not specified	19(26)	3(9)	16(40)

SAMU: Service d'aide médicale urgente; SMUR: Service mobile d'urgence et réanimation

Table 2. Clinical findings among cocaine intoxicated pediatric patients admitted between 2010 and 2020 to French pediatric emergency departments compared to the Armenian et al. [7] study (percentage in columns).

Years	2010 – 2020					1997–2010
Type of unit	Pediatric emergency departments (France)					Armenian et al. [7] (California, USA)
Patients, n	74		34			36
Age, years	<15 years	%	< 6 years	%	P value*	< 6 years	%
Median, years	3.2		1.0			1.5
[range]	[1 day-14.8 years]		[1 day-5 years]			[3days-5 years]
Symptoms, n	53	72	23	68	0.48	33	92
Neurological	44	59	19	56	0.10	31	86
Drowsiness	15	20	3	9	0.03	Not specified	-
Agitation	11	15	6	18	0.54	9	25
Coma	6	8	2	6	0.52	8	22
Seizures	6	8	3	9	0.84	12	33
Ataxia	2	3	1	3	–	2	6
Vertigo	1	–	–	–	–	–	–
Hypotonia	1	–	2	6	–	–	–
Hypertonia	1	–	1	3	–	–	–
Tremor, fasciculations	1	–	1	3	–	–	–
Cardiovascular	25	34	14	41	0.22	24	67
Tachycardia	13	18	11	32	0.007	18	50
Bradycardia	3	4	–	–	–	–	–
Hypertension	3	4	3	9	0.09	5	14
Hypotension	6	8	0	–	–
Cardiac arrest	–	–	–	–	–	1	3
Ophthalmological	12	16	6	18	0.77	3	8
Mydriasis	12	16	6	18	–	3	8
Respiratory	7	9	6	18	0.04	7	19
Hypoventilation	6	8	5	15	–	4	11
Tachypnea	1	–	1	3	–	Not specified	-
Gastrointestinal	7	9	4	12	0.53	6	17
Abdominal pain	3	4	2	6	–	Not specified	-
Vomiting	3	4	1	3	–	Not specified	-
Diarrhea	1	–	1	3	–	Not specified	-
Rhabdomyolysis	3	4	1	3	0.66	1	3
Temperature	10	13	5	15	0.54	5	14
Hyperthermia (≥38.5 °C)	4	5	4	12	–	5	14
Hypothermia (<36 °C)	6	8	1	3	–	–	–
Disposition
Hospitalization	56	76	32	94	0.003	27	75
PICU	12	16	8	24	0.12	14	39
Assisted ventilation	2	3	2	6	0.20	3	8

*Pcompares children under 6 years of age and older children. PICU: pediatric intensive care unit

Table 3. List of other substances detected by toxicologic analysis in children with cocaine exposure/intoxication.

Other substances detected (n = 18)	Total patients (n = 46)	%	Age group < 6 years (n = 16)	%
Cannabis	30	65	5	31
Benzodiazepines	12	26	1	6
Amfetamines	8	17	4	25
Alcohol	3	6	1	6
Opioids	3	6	1	6
Paracetamol	3	6	2	12
Methadone	2	4	1	6
Zopiclone	2	4	1	6
Levamisole	2	4	–	–
Gamma hydroxybutyrate (GHB)	2	4	2	12
Lidocaine	2	4	2	12
Buprenorphine	1	–	–	–
Clozapine	1	–	1	6
Carbamazepine	1	–	1	6
Heroin	1	–	–	–
Caffeine	1	–	–	–
Ammonia	1	–	1	6
Carbon monoxide	1	–	1	6

Data availability statement

Deidentified individual participant data will not be made available.