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Open Access 01-12-2021 | Intoxication | Research article

The role of tobacco smoking and illicit drug use in adolescent acute alcohol intoxication

Authors: Loes de Veld, Inge M. Wolberink, Joris J. van Hoof, Nico van der Lely

Published in: BMC Pediatrics | Issue 1/2021

Abstract

Background

This study aims to determine the prevalence of tobacco smoking and illicit drug use among Dutch adolescents admitted to hospital for acute alcohol intoxication treatment. Furthermore, socio-demographic predictors for smoking and illicit drug use in the sample population will be studied. The relationship between illicit drug use and specific characteristics of intoxication, such as blood alcohol concentration (BAC) and duration of reduced consciousness is also investigated.

Methods

The national Dutch Paediatric Surveillance Unit was used to prospectively register cases of acute alcohol intoxication from 2007 through 2017. Cases were included if they met the following inclusion criteria: BAC > 0.0 g/L, aged between 10 to 18 years old and requiring hospital treatment due to reduced consciousness. Questionnaires were sent to paediatricians to obtain clinical information.

Results

During the period 2007–2017, 5322 cases that met the inclusion criteria were reported. In this patient group, the prevalence of tobacco smoking was 22.2% (CI 21.0–23.5%), while the prevalence of illicit drug use was 11.8% (CI 10.9–12.7%). The predictors for smoking were the absence of alcohol-specific parental rule-setting, lower educational level, non-traditional family structure and positive drug screening. The predictors for illicit drug use were the absence of alcohol-specific parental rule-setting and smoking. Illicit drug use was also associated with a lower BAC at the time of admission.

Conclusions

Assessing smoking and illicit drug use among adolescents admitted for acute alcohol intoxication is important in acute cases of intoxication, for outpatient follow-up and for the purposes of prevention. The relationship between simultaneous illicit drug use and a lower BAC is of relevance for paediatricians’ attempts to diagnose acute intoxication. With respect to outpatient follow-up and preventive measures, it is important to be aware that adolescents’ alcohol consumption, tobacco and illicit drug use are related and, ultimately, increase the odds of using other substances.

Casey BJ, Jones RM. Neurobiology of the adolescent brain and behavior: implications for substance use disorders. J Am Acad Child Adolesc Psychiatry. 2010;49(12):1189–201. https://doi.org/10.1016/j.jaac.2010.08.017.CrossRefPubMedPubMedCentral

Chambers RA, Taylor JR, Potenza MN. Developmental neurocircuitry of motivation in adolescence: a critical period of addiction vulnerability. Am J Psychiatry. 2003;160(6):1041–52. https://doi.org/10.1176/appi.ajp.160.6.1041.CrossRefPubMedPubMedCentral

The Lancet Public Health. Addressing youth drinking. Lancet Public Health. 2018;3(2):e52. https://doi.org/10.1016/S2468-2667(18)30010-0.CrossRefPubMed

Spear LP. The adolescent brain and age-related behavioral manifestations. Neurosci Biobehav Rev. 2000;24(4):417–63. https://doi.org/10.1016/s0149-7634(00)00014-2.CrossRefPubMed

Steinberg L. A social neuroscience perspective on adolescent risk-taking. Dev Rev. 2008;28(1):78–106. https://doi.org/10.1016/j.dr.2007.08.002.CrossRefPubMedPubMedCentral

Gardner M, Steinberg L. Peer influence on risk taking, risk preference, and risky decision making in adolescence and adulthood: an experimental study. Dev Psychol. 2005;41(4):625–35. https://doi.org/10.1037/0012-1649.41.4.625.CrossRefPubMed

Reyna VF, Farley F. Risk and rationality in adolescent decision making: implications for theory, practice, and public policy. Psychol Sci Public Interest. 2006;7(1):1–44. https://doi.org/10.1111/j.1529-1006.2006.00026.x.CrossRefPubMed

Groß C, Kraus L, Piontek D, Reis O, Zimmermann US, Bitzer EM, et al. Prediction of long-term outcomes in young adults with a history of adolescent alcohol-related hospitalization. Alcohol Alcohol. 2016;51(1):47–53. https://doi.org/10.1093/alcalc/agv072.CrossRefPubMed

Lewer D, Freer J, King E, Larney S, Degenhardt L, Tweed EJ, et al. Frequency of health-care utilization by adults who use illicit drugs: a systematic review and meta-analysis. Addiction. 2020;115(6):1011–23. https://doi.org/10.1111/add.14892.CrossRefPubMedPubMedCentral

10.

Pennings EJ, Leccese AP, Wolff FA. Effects of concurrent use of alcohol and cocaine. Addiction. 2002;97(7):773–83. https://doi.org/10.1046/j.1360-0443.2002.00158.x.CrossRefPubMed

11.

Andrews P. Cocaethylene toxicity. J Addict Dis. 1997;16(3):75–84. https://doi.org/10.1300/J069v16n03_08.CrossRefPubMed

12.

Kirkpatrick MG, Gunderson EW, Levin FR, Foltin RW, Hart CL. Acute and residual interactive effects of repeated administrations of oral methamphetamine and alcohol in humans. Psychopharmacology. 2012;219(1):191–204. https://doi.org/10.1007/s00213-011-2390-5.CrossRefPubMed

13.

Galicia M, Dargan PI, Dines AM, Yates C, Heyerdahl F, Hovda KE, et al. Clinical relevance of ethanol coingestion in patients with GHB/GBL intoxication. Toxicol Lett. 2019;314:37–42. https://doi.org/10.1016/j.toxlet.2019.07.001.CrossRefPubMed

14.

Liechti ME, Kunz I, Greminger P, Speich R, Kupferschmidt H. Clinical features of gamma-hydroxybutyrate and gamma-butyrolactone toxicity and concomitant drug and alcohol use. Drug Alcohol Depend. 2006;81(3):323–6. https://doi.org/10.1016/j.drugalcdep.2005.07.010.CrossRefPubMed

15.

Brière FN, Fallu JS, Descheneaux A, Janosz M. Predictors and consequences of simultaneous alcohol and cannabis use in adolescents. Addict Behav. 2011;36(7):785–8. https://doi.org/10.1016/j.addbeh.2011.02.012.CrossRefPubMed

16.

Subbaraman MS, Kerr WC. Simultaneous versus concurrent use of alcohol and cannabis in the National Alcohol Survey. Alcohol Clin Exp Res. 2015;39(5):872–9. https://doi.org/10.1111/acer.12698.CrossRefPubMedPubMedCentral

17.

Yurasek AM, Aston ER, Metrik J. Co-use of alcohol and Cannabis: a review. Curr Addict Rep. 2017;4(2):184–93. https://doi.org/10.1007/s40429-017-0149-8.CrossRefPubMedPubMedCentral

18.

Coomber K, Curtis A, Vandenberg B, Miller PG, Heilbronn C, Matthews S, et al. Aggression and violence at ambulance attendances where alcohol, illicit and/or pharmaceutical drugs were recorded: a 5-year study of ambulance records in Victoria, Australia. Drug Alcohol Depend. 2019;205:107685. https://doi.org/10.1016/j.drugalcdep.2019.107685.CrossRefPubMed

19.

Jordan A, Salen P, Wojda TR, Cohen MS, Hasani A, Luster J, et al. Exploring the association between initial serum alcohol concentration and polysubstance use: more than a simple “gateway drug” effect. Int J Crit Illn Inj Sci. 2018;8(4):201–6. https://doi.org/10.4103/IJCIIS.IJCIIS_65_18.CrossRefPubMedPubMedCentral

20.

Yoon Y, Lee JO, Cho J, Bello MS, Khoddam R, Riggs NR, et al. Association of Cyberbullying Involvement with Subsequent Substance use among Adolescents. J Adolesc Health. 2019;65(5):613–20. https://doi.org/10.1016/j.jadohealth.2019.05.006.CrossRefPubMedPubMedCentral

21.

Jackson C, Sweeting H, Haw S. Clustering of substance use and sexual risk behaviour in adolescence: analysis of two cohort studies. BMJ Open. 2012;2(1):e000661. https://doi.org/10.1136/bmjopen-2011-000661.CrossRefPubMedPubMedCentral

22.

McCambridge J, McAlaney J, Rowe R. Adult consequences of late adolescent alcohol consumption: a systematic review of cohort studies. PLoS Med. 2011;8(2):e1000413. https://doi.org/10.1371/journal.pmed.1000413.CrossRefPubMedPubMedCentral

23.

Swendsen J, Burstein M, Case B, Conway KP, Dierker L, He J, et al. Use and abuse of alcohol and illicit drugs in US adolescents: results of the National Comorbidity Survey-Adolescent Supplement. Arch Gen Psychiatry. 2012;69(4):390–8. https://doi.org/10.1001/archgenpsychiatry.2011.1503.CrossRefPubMedPubMedCentral

24.

Hale DR, Viner RM. The correlates and course of multiple health risk behaviour in adolescence. BMC Public Health. 2016;16(1):458. https://doi.org/10.1186/s12889-016-3120-z.CrossRefPubMedPubMedCentral

25.

Riala K, Hakko H, Isohanni M, Järvelin MR, Räsänen P. Teenage smoking and substance use as predictors of severe alcohol problems in late adolescence and in young adulthood. J Adolesc Health. 2004;35(3):245–54. https://doi.org/10.1016/j.jadohealth.2003.08.016.CrossRefPubMed

26.

Hair EC, Park MJ, Ling TJ, Moore KA. Risky behaviors in late adolescence: co-occurrence, predictors, and consequences. J Adolesc Health. 2009;45(3):253–61. https://doi.org/10.1016/j.jadohealth.2009.02.009.CrossRefPubMed

27.

Verplaetse TL, McKee SA. An overview of alcohol and tobacco/nicotine interactions in the human laboratory. Am J Drug Alcohol Abuse. 2017;43(2):186–96. https://doi.org/10.1080/00952990.2016.1189927.CrossRefPubMed

28.

Maasland DH, van den Brandt PA, Kremer B, Goldbohm RA, Schouten LJ. Alcohol consumption, cigarette smoking and the risk of subtypes of head-neck cancer: results from the Netherlands cohort study. BMC Cancer. 2014;14(1):187. https://doi.org/10.1186/1471-2407-14-187.CrossRefPubMedPubMedCentral

29.

Degenhardt L, Hall W. The relationship between tobacco use, substance-use disorders and mental health: results from the National Survey of mental health and well-being. Nicotine Tob Res. 2001;3(3):225–34. https://doi.org/10.1080/14622200110050457.CrossRefPubMed

30.

Pelucchi C, Gallus S, Garavello W, Bosetti C, La Vecchia C. Cancer risk associated with alcohol and tobacco use: focus on upper aero-digestive tract and liver. Alcohol Res Health. 2006;29(3):193–8.PubMedPubMedCentral

31.

Hagger-Johnson G, Sabia S, Brunner EJ, Shipley M, Bobak M, Marmot M, et al. Combined impact of smoking and heavy alcohol use on cognitive decline in early old age: Whitehall II prospective cohort study. Br J Psychiatry. 2013;203(2):120–5. https://doi.org/10.1192/bjp.bp.112.122960.CrossRefPubMedPubMedCentral

32.

Weitzman ER, Chen YY. The co-occurrence of smoking and drinking among young adults in college: national survey results from the United States. Drug Alcohol Depend. 2005;80(3):377–86. https://doi.org/10.1016/j.drugalcdep.2005.05.008.CrossRefPubMed

33.

Adams S. Psychopharmacology of tobacco and alcohol comorbidity: a review of current evidence. Curr Addict Rep. 2017;4(1):25–34. https://doi.org/10.1007/s40429-017-0129-z.CrossRefPubMedPubMedCentral

34.

Kraus L, Guttormsson U, Leifman H, Arpa S, Molinaro S, Monshouwer K, et al. Results from the european school survey project on alcohol and other drugs; 2016. https://doi.org/10.2810/86718.CrossRef

35.

De Witt S, Hupkens C. Alcoholgebruik en gezondheid. Central Bureau of Statistics, Accessed 7 Nov 2020. https://longreads.cbs.nl/jeugdmonitor-2018/alcoholgebruik-en-gezondheid

36.

Peacock A, Leung J, Larney S, Colledge S, Hickman M, Rehm J, et al. Global statistics on alcohol, tobacco and illicit drug use: 2017 status report. Addiction. 2018;113(10):1905–26. https://doi.org/10.1111/add.14234.CrossRefPubMed

37.

Romer D, Reyna VF, Satterthwaite TD. Beyond stereotypes of adolescent risk taking: placing the adolescent brain in developmental context. Dev Cogn Neurosci. 2017;27:19–34. https://doi.org/10.1016/j.dcn.2017.07.007.CrossRefPubMedPubMedCentral

38.

Casey BJ, Jones RM, Hare TA. The adolescent brain. Ann N Y Acad Sci. 2008;1124(1):111–26. https://doi.org/10.1196/annals.1440.010.CrossRefPubMedPubMedCentral

39.

Giedd JN. Structural magnetic resonance imaging of the adolescent brain. Ann N Y Acad Sci. 2004;1021(1):77–85. https://doi.org/10.1196/annals.1308.009.CrossRefPubMed

40.

Vanyukov MM, Tarter RE, Kirillova GP, Kirisci L, Reynolds MD, Kreek MJ, et al. Common liability to addiction and “gateway hypothesis”: theoretical, empirical and evolutionary perspective. Drug Alcohol Depend. 2012;123(Suppl 1):S3–17. https://doi.org/10.1016/j.drugalcdep.2011.12.018.CrossRefPubMedPubMedCentral

41.

Reyna VF, Huettel SA. Reward, representation, and impulsivity: a theoretical framework for the neuroscience of risky decision making. In: Reyna VF, Zayas V, editors. Bronfenbrenner series on the ecology of human development. The neuroscience of risky decision making: American Psychological Association; 2014. p. 11–42. https://doi.org/10.1037/14322-002.

42.

Kandel DB. Examining the gateway hypothesis: stages and pathways of drug involvement. In: Kandel DB, editor. Stages and pathways of drug involvement: examining the gateway hypothesis. Cambridge: Cambridge University Press; 2002a.CrossRef

43.

Grunberg NE, Faraday MM. The value of animal models to examine the Gateway Hypothesis. In: Kandel DB, editor. Stages and pathways of drug involvement: examining the gateway hypothesis. Cambridge: Cambridge University Press; 2002.

44.

Falconer DS. The inheritance of liability to certain diseases, estimated from the incidence among relatives. Ann Hum Genet. 1965;29(1):51–76. https://doi.org/10.1111/j.1469-1809.1965.tb00500.x.CrossRef

45.

Staff J, Patrick ME, Loken E, Maggs JL. Teenage alcohol use and educational attainment. J Stud Alcohol Drugs. 2008;69(6):848–58. https://doi.org/10.15288/jsad.2008.69.848.CrossRefPubMedPubMedCentral

46.

Rosoff DB, Clarke TK, Adams MJ, McIntosh AM, Davey Smith G, Jung J, et al. Educational attainment impacts drinking behaviors and risk for alcohol dependence: results from a two-sample Mendelian randomization study with ~780,000 participants. Mol Psychiatry. 2021;26(4):1119–32. https://doi.org/10.1038/s41380-019-0535-9.CrossRefPubMed

47.

Heradstveit O, Skogen JC, Hetland J, Hysing M. Alcohol and illicit drug use are important factors for school-related problems among adolescents. Front Psychol. 2017;8:1023. https://doi.org/10.3389/fpsyg.2017.01023.CrossRefPubMedPubMedCentral

48.

Ryan SM, Jorm AF, Lubman DI. Parenting factors associated with reduced adolescent alcohol use: a systematic review of longitudinal studies. Aust New Zealand J Psychiatry. 2010;44(9):774–83. https://doi.org/10.1080/00048674.2010.501759.CrossRef

49.

Sharmin S, Kypri K, Khanam M, Wadolowski M, Bruno R, Attia J, et al. Effects of parental alcohol rules on risky drinking and related problems in adolescence: systematic review and meta-analysis. Drug Alcohol Depend. 2017;178:243–56. https://doi.org/10.1016/j.drugalcdep.2017.05.011.CrossRefPubMed

50.

Wills TA, Yaeger AM. Family factors and adolescent substance use: models and mechanisms. Curr Dir Psychol Sci. 2003;12(6):222–6. https://doi.org/10.1046/j.0963-7214.2003.01266.x.CrossRef

51.

Institute of Medicine (US) Committee on Assessing Interactions Among Social, Behavioral, and Genetic Factors in Health, Hernandez LM, Blazer DG. Genes, behavior, and the social environment: moving beyond the nature/nurture debate. In: Genetic, environmental, and personality determinants of health risk behaviors. Washington (DC): National Academies Press (US); 2006.

52.

Patrick ME, Fleming CB, Fairlie AM, Lee CM. Cross-fading motives for simultaneous alcohol and marijuana use: associations with young adults’ use and consequences across days. Drug Alcohol Depend. 2020. https://doi.org/10.1016/j.drugalcdep.2020.108077.

53.

Lee CM, Cadigan JM, Patrick ME. Differences in reporting of perceived acute effects of alcohol use, marijuana use, and simultaneous alcohol and marijuana use. Drug Alcohol Depend. 2017;180:391–4. https://doi.org/10.1016/j.drugalcdep.2017.08.029.CrossRefPubMedPubMedCentral

54.

Hartman RL, Brown TL, Milavetz G, Spurgin A, Gorelick DA, Gaffney G, et al. Controlled Cannabis vaporizer administration: blood and plasma cannabinoids with and without alcohol. Clin Chem. 2015;61(6):850–69. https://doi.org/10.1373/clinchem.2015.238287.CrossRefPubMed

55.

Hernández-López C, Farré M, Roset PN, Menoyo E, Pizarro N, Ortuño J, et al. 3,4-Methylenedioxymethamphetamine (ecstasy) and alcohol interactions in humans: psychomotor performance, subjective effects, and pharmacokinetics. J Pharmacol Exp Ther. 2002;300(1):236–44. https://doi.org/10.1124/jpet.300.1.236.CrossRefPubMed

56.

Dumont GJ, Kramers C, Sweep FC, Willemsen JJ, Touw DJ, Schoemaker RC, et al. Ethanol co-administration moderates 3,4-methylenedioxymethamphetamine effects on human physiology. J Psychopharmacol. 2010;24(2):165–74. https://doi.org/10.1177/0269881108100020.CrossRefPubMed

57.

Mohamed WM, Ben Hamida S, Cassel JC, de Vasconcelos AP, Jones BC. MDMA: interactions with other psychoactive drugs. Pharmacol Biochem Behav. 2011;99(4):759–74. https://doi.org/10.1016/j.pbb.2011.06.032.CrossRefPubMed

58.

Boyer CS, Petersen DR. Enzymatic basis for the transesterification of cocaine in the presence of ethanol: evidence for the participation of microsomal carboxylesterases. J Pharmacol Exp Ther. 1992;260(3):939–46.PubMed

59.

Harris DS, Everhart ET, Mendelson J, Jones RT. The pharmacology of cocaethylene in humans following cocaine and ethanol administration. Drug Alcohol Depend. 2003;72(2):169–82. https://doi.org/10.1016/s0376-8716(03)00200-x.CrossRefPubMed

60.

Gottschalk PC, Kosten TR. Cerebral perfusion defects in combined cocaine and alcohol dependence. Drug Alcohol Depend. 2002;68(1):95–104. https://doi.org/10.1016/s0376-8716(02)00109-6.CrossRefPubMed

61.

Merrin GJ, Thomson K, Leadbeater BJ. Transitions in the use of multiple substances from adolescence to young adulthood. Drug Alcohol Depend. 2018;189:147–53. https://doi.org/10.1016/j.drugalcdep.2018.05.015.CrossRefPubMed

Title: The role of tobacco smoking and illicit drug use in adolescent acute alcohol intoxication
Authors: Loes de Veld
Inge M. Wolberink
Joris J. van Hoof
Nico van der Lely
Publication date: 01-12-2021
Publisher: BioMed Central
Keyword: Intoxication
Published in: BMC Pediatrics / Issue 1/2021
Electronic ISSN: 1471-2431
DOI: https://doi.org/10.1186/s12887-021-02710-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

The role of tobacco smoking and illicit drug use in adolescent acute alcohol intoxication

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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