Получена: 07.10.2023 Принята: 02.02.2024 Опубликована online: 29.02.2024
УДК 616-053.2
DOI 10.53511/PHARMKAZ.2024.89.95.018
Жумашева Айгерим Сапаровна, 1Прилуцкая Мария Валерьевна, 1Шарапатова Куляш Гаусильевна, 2 Алтыбаева Гульжан Калибековна, 3Шамарданова Ольга Минневакифовна, 3Кусаинов Алмас Абихасович
1Павлодарский филиал НАО «Медицинский университет Семей», г. Павлодар, Казахстан
2Медицинский университет Семей, г. Семей, Казахстан
3Медицинский Университет Астана, г. Астана, Казахстан
ПРОБЛЕМА УПОТРЕБЛЕНИЯ ПСИХОАКТИВНЫХ ВЕЩЕСТВ В ПЕДИАТРИЧЕСКОЙ
ПРАКТИКЕ: СОМАТИЧЕСКИЕ АСПЕКТЫ. ОБЗОР ЛИТЕРАТУРЫ
Введение. Употребление психоактивных веществ (ПАВ) среди подростков и детей является важной проблемой общественного здравоохранения во всем мире. По причине широкой распространенности ПАВ, губительности последствий их приема педиатрам амбулаторного и стационарного звена необходимо знать клинические проявления злоупотребления ПАВ у детей и подростков.
Цель: анализ литературных данных о соматических аспектах употребления ПАВ в педиатрической практике.
Материалы и методы. Проведен обзор оригинальных научных публикаций на английском, русском
языках из баз данных: PubMed, Scopus, DOAJ. Критериями включения стали полнотекстовые оригинальные публикации о клинических аспектах употребления ПАВ детьми и подростками. Глубина
поиска: январь 2013 года- май 2023 года. Критериями исключения были абстракты и резюме публикаций, статьи о злоупотреблении ПАВ взрослыми.
Результаты. В обзоре представлены данные о соматических симптомах интоксикации каннабисом,
ингалянтами, галлюциногенами, бензодиазепинами, опиоидами, кокаином, вейпами, новыми психоактивными веществами у несовершеннолетних.
Выводы. Количество новых психоактивных веществ растет, как и число злоупотребляющих ими
подростками. Интоксикация ПАВ в педиатрической практике проявляется разнообразной симптоматикой. Данный обзор подчеркивает важность работы с данной проблемой по нескольким направлениям: своевременная оценка состояния и дифференцирование ПАВ по тяжести соматических аспектов, выявление факторов риска и настороженность по злоупотреблению ПАВ и хронизации патологических процессов, а также проведение комплексных мер фокусной профилактики
в группах риска.
Ключевые слова: каннабис, ингалянты, галлюциногены, бензодиазепины, опиоиды, кокаин, вейпинг,
«дизайнерские наркотики», дети, подростки, отравление.
СПИСОК ЛИТЕРАТУРЫ
1 Whitesell M, Bachand A, Peel J, Brown M. Familial, social, and individual factors contributing to risk for adolescent substance use. J Addict. 2013;
2013:579310. doi: 10.1155/2013/579310.
2 Barnard M, McKeganey N. The impact of parental problem drug use on children: what is the problem and what can be done to help? Addiction. 2004;99(5):
552-559. doi: 10.1111/j.1360-0443.2003.00664.x.
3 Mokdad AH, Forouzanfar MH, Daoud F, Mokdad AA, El Bcheraoui C, Moradi-Lakeh M, Global burden of diseases, injuries, and risk factors for young
people’s health during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2016;387(10036):2383-2401. doi:10.1016/
S0140-6736(16)00648-6
4 Thomasius R, Paschke K, Arnaud N. Substance-Use Disorders in Children and Adolescents. Dtsch Arztebl Int. 2022;119(25):440-450. doi:10.3238/arztebl.
m2022.0122
5 Lopes GM, Nóbrega BA, Del Prette G, Scivoletto S. Use of psychoactive substances by adolescents: current panorama. Braz J Psychiatry. 2013;35 Suppl
1:S51-S61. doi:10.1590/1516-4446-2013-S105
6 Adebanke OI, Ogundipe O, Amoo E, Adeloye D. Substance use among adolescents in sub-Saharan Africa: a systematic review and meta-analysis. South
African J Child Heal. 2018 Sep 4;12:79. doi: 10.7196/SAJCH.2018.v12i2b.1524
7 Tsvetkova L, Antonova N. The prevalence of drug use among university students in St. Petersburg, Russia. Psychol Russ State Art. 2013 Jan 1;6:86–94.
doi:10.11621/pir.2013.0108
8 Pengpid S, Peltzer K. Early Substance Use Initiation And Psychological Distress Among Adolescents In Five ASEAN Countries: A Cross-Sectional Study.
Psychol Res Behav Manag. 2019;12:1003-1008. doi:10.2147/PRBM.S223624
9 Алтынбеков КС, Негай НА, Абетова АА. Методология и результаты национального исследования по потреблению психоактивных веществ среди
молодежи в Республике Казахстан. Вестник КазНМУ. 2021;4:193–201. doi:10.53065/kaznmu.2021.89.13.033
10 Prilutskaya M, Yussopov O, Negay N, Altynbekov K, Tokayeva M. Prevalence of new psychoactive substances addiction: a hospital-based cross-sectional
study. J Clin Med Kazakhstan. 2020;1(55):11–6. doi:10.23950/1812-2892-JCMK-00730
11 Di Forti M, Quattrone D, Freeman TP, Tripoli G, Gayer-Anderson C, Quigley H, et al. The contribution of cannabis use to variation in the incidence of
psychotic disorder across Europe (EU-GEI): a multicentre case-control study. Lancet Psychiatry. 2019;6(5):427-436. doi:10.1016/S2215-0366(19)30048-3
12 Garofoli M. Adolescent Substance Abuse. Prim Care. 2020;47(2):383-394. doi:10.1016/j.pop.2020.02.013
13 Shollenbarger SG, Price J, Wieser J, Lisdahl K. Poorer frontolimbic white matter integrity is associated with chronic cannabis use, FAAH genotype, and
increased depressive and apathy symptoms in adolescents and young adults. Neuroimage Clin. 2015;8:117-125. doi:10.1016/j.nicl.2015.03.024
14 Lin L, Jung KM, Lee HL, Le J, Colleluori G, Wood C, Palese F, Squire E, Ramirez J, Su S, Torrens A, Fotio Y, Tang L, Yu C, Yang Q, Huang L, DiPatrizio
N, Jang C, Cinti S, Piomelli D. Adolescent exposure to low-dose THC disrupts energy balance and adipose organ homeostasis in adulthood. Cell Metab.
2023;35(7):1227-1241.e7. doi:10.1016/j.cmet.2023.05.002
15 Renard J, Szkudlarek HJ, Kramar CP, Jobson CEL, Moura K, Rushlow WJ, Laviolette SR. Adolescent THC Exposure Causes Enduring Prefrontal Cortical
Disruption of GABAergic Inhibition and Dysregulation of Sub-Cortical Dopamine Function. Sci Rep. 2017;7(1):11420. doi:10.1038/s41598-017-11645-8
16 Wright NE, Scerpella D, Lisdahl KM. Marijuana Use Is Associated with Behavioral Approach and Depressive Symptoms in Adolescents and Emerging
Adults. PLoS One. 2016;11(11):e0166005. doi:10.1371/journal.pone.0166005
17 Nappe TM, Hoyte CO. Pediatric Death Due to Myocarditis After Exposure to Cannabis. Clin Pract Cases Emerg Med. 2017;1(3):166-170. doi:10.5811/
cpcem.2017.1.33240
18 Appelboam A, Oades PJ. Coma due to cannabis toxicity in an infant. Eur J Emerg Med. 2006;13(3):177-179. doi:10.1097/01.mej.0000194405.38206.f2
19 Schreier MD, Williams C, Ma TM. Cardiac Ischemia Associated With Marijuana Use in an Adolescent. Cureus. 2020;12(8):e9661. doi:10.7759/cureus.9661
20 Basnet S, Mander G, Nicolas R. Coronary vasospasm in an adolescent resulting from marijuana use. Pediatr Cardiol. 2009;30(4):543-545. doi:10.1007/
s00246-009-9384-7
21 Posis A, Bellettiere J, Liles S, Alcaraz J, Nguyen B, Berardi V, Klepeis NE, Hughes SC, Wu T, Hovell MF. Indoor cannabis smoke and children’s health. Prev
Med Rep. 2019;14:100853. doi:10.1016/j.pmedr.2019.100853
22 Wilson KM, Torok MR, Wei B, Wang L, Robinson M, Sosnoff CS, Blount BC. Detecting biomarkers of secondhand marijuana smoke in young children.
Pediatr Res. 2017;81(4):589-592. doi:10.1038/pr.2016.261
23 Lonsdale, H., Kimsey, K. M., Brown, J. M., Dey, A., Peck, J., Son, S., & Wilsey, M. (2021). Pediatric Cannabinoid Hyperemesis: A Single Institution
10-Year Case Series. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 68(2), 255–261. https://doi.org/10.1016/j.
jadohealth.2020.09.024
24 Braunscheidel KM, Gass JT, Mulholland PJ, Floresco SB, Woodward JJ. Persistent cognitive and morphological alterations induced by repeated exposure
of adolescent rats to the abused inhalant toluene. Neurobiol Learn Mem. 2017;144:136-146. doi:10.1016/j.nlm.2017.07.007
25 Lee MY, Lin BF, Chan MH, Chen HH. Increased behavioral and neuronal responses to a hallucinogenic drug after adolescent toluene exposure in mice:
Effects of antipsychotic treatment. Toxicology. 2020;445:152602. doi:10.1016/j.tox.2020.152602
26 Crossin R, Qama A, Andrews ZB, Lawrence AJ, Duncan JR. The effect of adolescent inhalant abuse on energy balance and growth. Pharmacol Res
Perspect. 2019;7(4):e00498. doi:10.1002/prp2.498
27 Levari E, Stefani M, Ferrucci R, Negri A, Corazza O. The dangerous use of inhalants among teens: A case report. Emerg Trends Drugs, Addict Heal.
2021;1:100006. doi:10.1016/j.etdah.2021.100006
28 Sironi L, Amadasi A, Zoja R. Recreational inhalation of butane and propane in adolescents: Two forensic cases of accidental death. Forensic Sci Int.
2016;266:e52-e58. doi:10.1016/j.forsciint.2016.05.028
29 Thulasirajah S, Michaud J, Doja A, McMillan HJ. Inhaled Solvent Abuse Mimicking Chronic Inflammatory Demyelinating Polyradiculoneuropathy. Child
Neurol Open. 2020;7:2329048X20934914. doi:10.1177/2329048X20934914
30 Hardaway R, Schweitzer J, Suzuki J. Hallucinogen Use Disorders. Child Adolesc Psychiatr Clin N Am. 2016;25(3):489-496. doi:10.1016/j.chc.2016.03.006
31 De Gregorio D, Posa L, Ochoa-Sanchez R, McLaughlin R, Maione S, Comai S, Gobbi G. The hallucinogen d-lysergic diethylamide (LSD) decreases
dopamine firing activity through 5-HT1A, D2 and TAAR1 receptors. Pharmacol Res. 2016;113(Pt A):81-91. doi:10.1016/j.phrs.2016.08.022
32 Olanrewaju JA, Iheanyichukwu O, Oladele OJ, Yinka OS, Taiye AS, Oluseyi FS. Garcina Kola neuroprotective effects on the prefrontal cortex cytoarchitecture of MDMA-induced neuroinflammation in male Wistar rats model. Phytomedicine Plus. 2022;2(1):100174. doi:10.1016/1.phyplu.2021.100174
33 Kiyatkin EA, Kim AH, Wakabayashi KT, Baumann MH, Shaham Y. Critical role of peripheral vasoconstriction in fatal brain hyperthermia induced by MDMA
(Ecstasy) under conditions that mimic human drug use. J Neurosci. 2014;34(23):7754-7762. doi:10.1523/JNEUROSCI.0506-14.2014
34 Adegoke, S. A., & Alo, L. A. (2013). Datura stramonium poisoning in children. Nigerian journal of clinical practice, 16(1), 116–118. https://doi.org/10.4103/1119-
3077.106783
35 Larivière, I., Garat, A., Nisse, P., & Mathieu-Nolf, M. (2012). Pediatric poisoning with triptans: review of cases in the Lille poison center between 2000 and
2010. Archives de pediatrie : organe officiel de la Societe francaise de pediatrie, 19(3), 254–259. https://doi.org/10.1016/j.arcped.2011.12.014
36 Bakr MH, Radwan E, Shaltout AS, A Farrag A, Mahmoud AR, Abd-Elhamid AH, Ali M. Chronic exposure to tramadol induces cardiac inflammation and
endothelial dysfunction in mice. Sci Rep. 2021;11(1):18772. doi:10.1038/s41598-021-98206-2
37 González Lago S, Pérez García MJ, Gomila I, Puiguriguer J, Barceló B. High-sensitivity troponin I elevation and hyperamylasemia in a pediatric case with
tramadol and morphine overdose. An Pediatr (Engl Ed). 2022;97(5):359-360. doi:10.1016/j.anpede.2022.09.003
38 Tanne C, Javouhey E, Millet A, Bordet F. Severe Tramadol Overdoses in Children: A Case Series Admitted to Paediatric Intensive Care Unit. J Clin Toxicol.
2016;6(5):1–5. doi:10.4172/2161-0495.1000317.
39 Chuang R, Saleh F, Alyahya B. Pediatric cardiac toxicity associated with fentanyl ingestion. Toxicol Commun. 2018 Jan 1;2(1):39–41. doi:10.1080/24734
306.2018.1459108
40 Moshiri M, Hedjazi A, Rezazadeh-Shojaie SM, Etemad L. Child Death Due to Dermal Opium Application: A Case Report. IJT. 2020 Jan 1;14(1):59–62.
doi:10.32598/ijt.14.1.59
41 Melikishvili A, Patel B, Hasbani DM, Carvalho KS. A Case Report of Myelopathy Following Heroin Overdose in a Child. Child Neurol Open.
2021;8:2329048X211030757. doi:10.1177/2329048X211030757
42 Tanne C, Javouhey E, Millet A, Bordet F. Severe Tramadol Overdoses in Children: A Case Series Admitted to Paediatric Intensive Care Unit. J Clin Toxicol.
2016;6(5):1–5. doi:10.4172/2161-0495.1000317
43 Sharif MR, Nouri S. Clinical Signs and Symptoms and Laboratory Findings of Methadone Poisoning in Children. Iran J Pediatr. 2015;25(1):e176. doi:10.5812/
ijp.176
44 Nygaard E, Slinning K, Moe V, Walhovd KB. Behavior and Attention Problems in Eight-Year-Old Children with Prenatal Opiate and Poly-Substance Exposure:
A Longitudinal Study. PLoS One. 2016;11(6):e0158054. doi:10.1371/journal.pone.0158054
45 Zhang J, Cheng H, Xue M, Xiong Y, Zhu Y, Björkegren JLM, Zhang Z, Chen J, Shi Z, Hao K. Effects of chronic electronic cigarettes exposure in inducing
respiratory function decline and pulmonary tissue injury — A direct comparison to combustible cigarettes. Ecotoxicol Environ Saf. 2023;249:114426. doi:10.1016/j.
ecoenv.2022.114426
46 Schaffer S, Strang A, Saul D, Krishnan V, Chidekel A. Adolescent E-cigarette or Vaping Use-Associated Lung Injury in the Delaware Valley: A Review of
Hospital-Based Presentation, Management, and Outcomes. Cureus. 2022;14(2):e21988. doi:10.7759/cureus.21988
47 Singh A. Adolescent e-cigarette or vaping product use-associated lung injury: A case series and review of the literature. Pediatr Pulmonol. 2022;57(4):1076-
1084. doi:10.1002/ppul.25832
48 Savage E, Dehmer J. Streptococcus intermedius empyema in an adolescent with a history of vaping: A case report. J Pediatr Surg Case Reports [Internet].
2023;92:102618. doi:10.1016/j.epsc.2023.102618.
49 El Chebib H, McArthur K, Gorbonosov M, Domachowske JB. Anaerobic Necrotizing Pneumonia: Another Potential Life-threatening Complication of Vaping?
Pediatrics. 2020;145(4):e20193204. doi:10.1542/peds.2019-3204
50 Bozkanat KM, Rao DR, Lieu TJ, Rivera-Sanchez YM. The perfect storm: A case of COVID-19 infection in an adolescent patient with EVALI. Respir Med
Case Rep. 2020;31:101306. doi:10.1016/j.rmcr.2020.101306
51 Phung B, Lam A. Pediatric Acute Respiratory Distress Syndrome and Hypersensitivity Pneumonitis Related to E-cigarette Vaping. J Pediatr Intensive Care.
2020;9(2):128-134. doi:10.1055/s-0039-3400961
52 Chadi N, Moore-Hepburn C, Beno S, Richmond SA. Vaping-related injury and illness among Canadian children and adolescents: a one-time survey of
paediatric providers. BMJ Paediatr Open. 2020;4(1):e000840. doi:10.1136/bmjpo-2020-000840
53 Arendt RE, Minnes S, Singer LT. Fetal Cocaine Exposure: Neurologic Effects and Sensory-Motor Delays. Phys Occup Ther Pediatr. 1996 Jan;16(1-2):129-
144. doi: 10.1080/J006v16n01_09. PMID: 25688173; PMCID: PMC4327946.
54 Perrine SA, Alsharif WF, Harutyunyan A, Kamal S, Viola NT, Gelovani JG. Low- and high-cocaine intake affects the spatial and temporal dynamics of class
IIa HDAC expression-activity in the nucleus accumbens and hippocampus of male rats as measured by [18F]TFAHA PET/CT neuroimaging. Addict Neurosci.
2022;4:100046. doi:10.1016/j.addicn.2022.100046
55 Castillo Díaz F, Mottarlini F, Targa G, Rizzi B, Fumagalli F, Caffino L. Recency memory is altered in cocaine-withdrawn adolescent rats: Implication of cortical
mTOR signaling. Prog Neuro-Psychopharmacology Biol Psychiatry. 2023;127:110822.
56 Claudet I, Caula C, Gallart JC, et al. A French study of cocaine intoxication/exposure in children (2010-2020). Clin Toxicol (Phila). 2023;61(5):370-378. do
i:10.1080/15563650.2023.2188143
57 De Knegt VE, Breindahl T, Harboe KM, Møller GL, Børresen ML. Gamma-hydroxybutyrate and cocaine intoxication in a Danish child. Clin Case Rep.
2016;4(3):228-231. Published 2016 Jan 11. doi:10.1002/ccr3.492
58 Becam J, Solas C, Casalta AC, Fabresse N. Intoxications pédiatriques à la cocaïne : une série de cas. Toxicol Anal Clin. 2023; doi:10.1016/j.toxac.2023.08.125
59 Ohns MJ. Unintentional Cocaine Exposure and Brugada Syndrome: A Case Report. J Pediatr Health Care. 2020;34(6):606-609. doi:10.1016/j.
pedhc.2020.06.009
60 Armenian P, Fleurat M, Mittendorf G, Olson KR. Unintentional Pediatric Cocaine Exposures Result in Worse Outcomes than Other Unintentional Pediatric
Poisonings. J Emerg Med. 2017;52(6):825-832. doi:10.1016/j.jemermed.2017.03.017
61 Fletcher É, Richard J, Derevensky J, Ivoska W, Temcheff C. Nonmedical Benzodiazepine Use in Adolescents: Indirect Effects of Internalizing and
Externalizing Symptoms. Int J Ment Health Addict. 2021;19(5):1410–9. doi:10.1007/s11469-020-00233-z
62 McCabe SE, West BT. Medical and nonmedical use of prescription benzodiazepine anxiolytics among U.S. high school seniors. Addict Behav.
2014;39(5):959-964. doi:10.1016/j.addbeh.2014.01.009
63 Friedrich JM, Sun C, Geng X, et al. Child and adolescent benzodiazepine exposure and overdose in the United States: 16 years of poison center data. Clin
Toxicol (Phila). 2020;58(7):725-731. doi:10.1080/15563650.2019.1674321
64 Soyka M. 3.22 — Sedatives and Hypnotics Abuse. Comprehensive Pharmacology. 2022;494–509. doi:10.1016/B978-0-12-820472-6.00033-5
65 Afzal A, Kiyatkin EA. Interactions of benzodiazepines with heroin: Respiratory depression, temperature effects, and behavior. Neuropharmacology.
2019;158:107677. doi:10.1016/j.neuropharm.2019.107677
66 Feliu C, Guillemin H, Gozalo C, et al. False negative on a proven involuntary intoxication in two children with lorazepam. Ann Biol Clin (Paris). 2017;75(1):83-
86. doi:10.1684/abc.2016.1209
67 Blumenberg A, Hughes A, Reckers A, Ellison R, Gerona R. Flualprazolam: Report of an Outbreak of a New Psychoactive Substance in Adolescents.
Pediatrics. 2020;146(1):e20192953. doi:10.1542/peds.2019-2953
68 Warrick BJ, Tataru AP, Gerona R. New Psychoactive Substances in Pediatric Patients. Pediatr Clin North Am. 2017;64(6):1223-1241. doi:10.1016/j.
pcl.2017.08.003
69 Adám A, Gerecsei LI, Lepesi N, Csillag A. Apoptotic effects of the ‘designer drug’ methylenedioxypyrovalerone (MDPV) on the neonatal mouse brain.
Neurotoxicology. 2014;44:231-236. doi:10.1016/j.neuro.2014.07.004
70 Engelgardt P, Krzyżanowski M, Borkowska-Sztachańska M, Wasilewska A, Ciucias M. Life time use of illicit substances among adolescents and young
people hospitalized in psychiatric hospital. Sci Rep. 2023;13(1):1–12. doi:10.1038/s41598-023-28603-2
71 Ahmadi I, Foruozandeh H. Evaluation the multi-organs toxicity of methamphetamine (METH) in rats. Toxicol Anal Clin. 2020;32(1):4–11. doi:10.1016/j.
toxac.2019.07.007
72 Zhao X, Lu J, Zhang C, et al. Methamphetamine induces cardiomyopathy through GATA4/NF-κB/SASP axis-mediated cellular senescence. Toxicol Appl
Pharmacol. 2023;466:116457. doi:10.1016/j.taap.2023.116457
73 Galinato MH, Orio L, Mandyam CD. Methamphetamine differentially affects BDNF and cell death factors in anatomically defined regions of the hippocampus.
Neuroscience. 2015;286:97-108. doi:10.1016/j.neuroscience.2014.11.042
74 Ciudad-Roberts A, Duart-Castells L, Camarasa J, Pubill D, Escubedo E. The combination of ethanol with mephedrone increases the signs of neurotoxicity
and impairs neurogenesis and learning in adolescent CD-1 mice. Toxicol Appl Pharmacol. 2016;293:10-20. doi:10.1016/j.taap.2015.12.019
75 Marszalek-Grabska M, Zakrocka I, Budzynska B, et al. Binge-like mephedrone treatment induces memory impairment concomitant with brain kynurenic
acid reduction in mice. Toxicol Appl Pharmacol. 2022;454:116216. doi:10.1016/j.taap.2022.116216
76 Aly SM, Omran A, Gaulier JM, Allorge D. Substance Use among Adolescents: A Retrospective Study (2017-2018) in the Toxicology Unit, University Hospital
of Lille, France. Toxics. 2022;10(10):594. doi:10.3390/toxics10100594
77 Morini L, Bernini M, Vezzoli S, Restori M, Moretti M, Crenna S, et al. Death after 25C-NBOMe and 25H-NBOMe consumption. Forensic Sci Int. 2017;279:e1–
6. doi:10.1016/j.forsciint.2017.08.028.
78 Barceló B, Pichini S, López-Corominas V, et al. Acute intoxication caused by synthetic cannabinoids 5F-ADB and MMB-2201: A case series. Forensic Sci
Int. 2017;273:e10-e14. doi:10.1016/j.forsciint.2017.01.020
79 Acharya R, Zeng X, Upadhyay K. Synthetic cannabinoid-associated acute interstitial nephritis: An emerging cause of pediatric acute kidney injury? Clin
Nephrol Case Stud. 2023;11:55-60. Published 2023 Mar 27. doi:10.5414/CNCS111063
80 Davis C, Boddington D. Teenage cardiac arrest following abuse of synthetic cannabis. Heart Lung Circ. 2015;24(10):e162-e163. doi:10.1016/j.hlc.2015.04.176
81 Buyukbese Sarsu S. Unusual side effect of cannabis use: acute abdomen due to duodenal perforation. Int J Emerg Med. 2016;9(1):18. doi:10.1186/s12245-
016-0114-7
82 Mohr AL, Friscia M, Papsun D, Kacinko SL, Buzby D, Logan BK. Analysis of Novel Synthetic Opioids U-47700, U-50488 and Furanyl Fentanyl by LC-MS/
MS in Postmortem Casework. J Anal Toxicol. 2016;40(9):709-717. doi:10.1093/jat/bkw086
83 Coopman V, Cordonnier J, De Leeuw M, Cirimele V. Ocfentanil overdose fatality in the recreational drug scene. Forensic Sci Int. 2016;266:469-473.
doi:10.1016/j.forsciint.2016.07.005
84 Tekulve K, Alexander A, Tormoehlen L. Seizures associated with synthetic cathinone exposures in the pediatric population. Pediatr Neurol. 2014;51(1):67-
70. doi:10.1016/j.pediatrneurol.2014.03.003
85 Cole JB, Dunbar JF, McIntire SA, Regelmann WE, Slusher TM. Butyrfentanyl overdose resulting in diffuse alveolar hemorrhage. Pediatrics.
2015;135(3):e740-e743. doi:10.1542/peds.2014-2878
86 Strommen J, Shirazi F. Methamphetamine Ingestion Misdiagnosed as Centruroides sculpturatus Envenomation. Case Rep Emerg Med. 2015;2015:320574.
doi:10.1155/2015/320574
87 Malashock HR, Yeung C, Roberts AR, Snow JW, Gerkin RD, O’Connor AD. Pediatric Methamphetamine Toxicity: Clinical Manifestations and Therapeutic
Use of Antipsychotics-One Institution’s Experience. J Med Toxicol. 2021;17(2):168-175. doi:10.1007/s13181-020-00821-4
88 Nebhinani N, Singh P, Nebhinani M. Substance Use Disorders in Children and Adolescents. J Indian Assoc Child Adolesc Ment Heal. 2022 Aug
5;18:097313422210965. doi:10.1177/09731342221096503
89 Pianca TG, Sordi AO, Hartmann TC, von Diemen L. Identification and initial management of intoxication by alcohol and other drugs in the pediatric
emergency room. J Pediatr (Rio J). 2017;93 Suppl 1:46-52. doi:10.1016/j.jped.2017.06.015
90 Barclay RP, Hilt RJ. Integrated Care for Pediatric Substance Abuse. Child Adolesc Psychiatr Clin N Am. 2016;25(4):769-777. doi:10.1016/j.chc.2016.05.00
91 Reichenheim, M. E., Interlenghi, G. S., Ferreira, M. F., & de Moraes, C. L. (2021). The Alcohol Use Disorders Identification Test (AUDIT) in Adolescents:
Using a Model-Based Approach to Identify Patterns of Alcohol Misuse. Substance use & misuse, 56(13), 1915–1922. https://doi.org/10.1080/10826084.202
1.1958859
