WIP 41 - Understanding the frequency of youth who present to hospital with substance use management needs

Publication Number: WIP 41.7424

Jessica Empringham, University of Toronto Temerty Faculty of Medicine, Toronto, ON, Canada; Karen Leslie, The Hospital for Sick Children, Toronto, ON, Canada

Background: Substance use and withdrawal management (WM) is an area of healthcare that requires systematic change to improve access for youth. In Ontario, there has been a consistent increase in youth who present to the emergency room for substance use concerns, with increase in repeat visits and in opioid related morbidity and mortality. Opioids, benzodiazepines and alcohol are the main substances that require medical WM. Paediatric substance use is area of urgency and evidence is lacking as to the frequency and nature of youth who present to hospital with WM needs.

Objective: This study aims to identify the frequency of youth who present to a paediatric hospital who require WM or who are at risk of withdrawal from substance use, and to understand trends over time. A secondary goal is to determine if youth are being adequately assessed for their risk of withdrawal.

Design/Methods: Utilizing a retrospective chart review, youth hospital presentations over 5 years (June 2018-May 2023) at SickKids will be examined. Charts will be chosen based on proxy measures that aim to identify those with or at risk of alcohol, benzodiazepine or opioid withdrawal. Measures utilized to identify youth who required WM support include Adolescent Medicine Consult, monitoring tools and medications used. Proxies to identify youth at risk include toxicology results and diagnoses that may be associated with withdrawal risk. An in-depth chart review will be completed to determine whether the youth received WM or if they were at risk. Information will be collected to determine if they were appropriately assessed for their risk using the STEPA algorithm. Demographic, presenting concern and disposition data will be collected. Data will be described as frequency of youth presenting over 5 years and a Mann-Kendall test will be used to identify temporal trends. Proportion of those that were adequately assessed for withdrawal will be analyzed using descriptive statistics. This study has REB approval and charts for review are being selected. Data collection will take place until January 2024, followed by analysis.