ArticleJAMA network open2024
Substance Use Emergency Department Visits Among Youths With Chronic Conditions During COVID-19.
Article in JAMA network open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed.
- Medical Diagnosis, ED Visits, and Hospitalizations for Substance Use in U.S. Children's Hospitals: A Retrospective Multi-Center Cohort Study.Children (Basel, Switzerland) · 2026Article
- Article
- Adolescent Substance Use Screening in the Emergency Department.Journal of the American College of Emergency Physicians open · 2026Review
- Growing Up Through a Pandemic: A Mixed-Methods Study of How the COVID-19 Pandemic Shaped the Transition to Adulthood for Youth With Special Healthcare Needs and Their Families.Child: care, health and development · 2026Article
- Health professional perspectives on integrating substance use services into pediatric hospitals for adolescents with chronic medical conditions.Discover health systems · 2026Article
- Family-based substance use screening and intervention for adolescents with chronic medical conditions: a study protocol to implement SBIRT-family within school-based health centers.Frontiers in health services · 2025Article
- Associations between COVID-19 impact and subsequent substance use in adolescents with chronic pain.Frontiers in pain research (Lausanne, Switzerland) · 2025Article
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8 authors.
Funding
Abstract
Importance: Pediatric emergency department (ED) visits for substance use (SU) increased during COVID-19. Better understanding of trends associated with SU ED visits among youths with a chronic medical condition (CMC) is needed to target SU screening, prevention, and intervention efforts in this population. Objective: To describe trends in pediatric SU ED visits before and during COVID-19 among youths in the US with and without CMCs and by race and ethnicity. Design, Setting, and Participants: In this cohort study, data were obtained from 47 US children's hospital EDs in the Pediatric Health Information System (PHIS) between March 1, 2018, and March 1, 2022. The cohort included patients aged 10 to 18 years. Data analysis occurred from November 2022 to February 2023. Exposures: ED visit occurrence before or during the COVID-19 pandemic and with or without the presence of a CMC. CMCs included chronic conditions (CCs) and complex CCs (CCCs). Main Outcomes and Measures: The primary outcome was the number of visits for an SU diagnosis based on diagnostic codes for youths with and without CMCs. Trends were assessed using logistic regression, adjusting for covariates and center effect. Results: The sample included 3 722 553 ED visits from March 1, 2018, to March 1, 2022 (1 932 258 aged 14-18 years [51.9%]; 1 969 718 female [52.9%]; 961 121 Hispanic [25.8%]; 977 097 non-Hispanic Black [26.2%]; 1 473 656 non-Hispanic White [39.6%]). Of all visits, 1 016 913 (27.3%) were youths with CCs and 367 934 (9.9%) were youths with CCCs. Youth SU ED visits increased for all groups during COVID-19. The SU ED visits increased by 23% for youths with CCs (21 357 visits [4.0%] to 23 606 visits [4.9%]), by 26% for youths with CCCs (3594 visits [1.9%] to 4244 visits [2.4%]), and by 50% for youths without CCs (4997 visits [0.4%] to 5607 visits [0.6%]). Furthermore, compared with youths without CCs, youths with CCs had consistently larger odds of SU than the other groups before COVID-19 (adjusted odds ratio, 9.74; 99% CI, 9.35-10.15) and during COVID-19 (adjusted odds ratio, 8.58; 99% CI, 8.25-8.92). The interaction between race and ethnicity and CMCs was significant (P for interaction < .001). Conclusions and Relevance: The findings of this cohort study suggest that providing SU services to all youths during times of societal crises is critical, but particularly for youths with CMCs who experience higher potential health impacts from SU given their medical concerns.
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