Substance-related visits to US children's hospitals increased 48% from 2016-2021, with cannabis accounting for 52% of visits and showing the greatest growth (82%), while Hispanic youth experienced the largest demographic increase.
Pediatricians, adolescent medicine providers, youth substance use prevention programs, health equity researchers
82.4% growth in cannabis-related visits
What the researchers found
From 2016-2021, substance-related visits increased 47.9% across all demographics. Cannabis accounted for 52.2% of visits and had 82.4% growth (p<0.001). Hispanic youth had the greatest demographic growth (63.3%). During the pandemic, publicly insured, female, non-Hispanic Black, and Hispanic youth exceeded predicted visit numbers.
Why it matters
Cannabis-related visits to children's hospitals growing at 82% far outpaces other substances and represents a significant and growing burden on pediatric healthcare. The disproportionate impact on minoritized youth adds an equity dimension.
The numbers in context
106,793 visits involving 84,632 youth. Cannabis: 52.2% of visits, 82.4% growth. Hispanic youth growth: 63.3%. Overall growth: 47.9%. All substances except sedatives increased.
How the study worked
Cross-sectional analysis of the Pediatric Health Information System database covering substance-related visits by youth ages 12-21 at children's hospitals from 2016-2021. ICD-10 codes identified visits for substance use, dependence, or overdoses. Time series analysis predicted pandemic-era expected visits.
What this study cannot tell us
Children's hospital data may not capture youth seen in adult facilities or community settings. ICD-10 coding practices vary. Cannot determine whether increases reflect more use, more severe use, or changes in healthcare-seeking behavior. Hospital-level data, not population-based.
How to read the evidence
National multi-hospital database provides broad trend data, but limited to children's hospitals and cannot assess population-level rates.
When this study was published
2024 analysis of Pediatric Health Information System data from 2016-2021
The bigger picture
The concentration of pandemic-era increases among publicly insured and minoritized youth suggests the pandemic amplified existing health disparities in adolescent substance use, with cannabis as the primary driver of the overall trend.
Questions still open
- What is driving the disproportionate increase among Hispanic youth? Are specific cannabis products (edibles, vapes) driving pediatric visits? Has the trend continued post-2021?
Common questions
Which substance drove the most children's hospital visits?
Did the pandemic make things worse?
Read the original research
Trends in Substance-Related Visits Among Youth to US Children's Hospitals, 2016-2021: An Analysis of the Pediatric Health Information System Database.
The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 75(1), 76-84
Citation
Ball, Alexis; Hadland, Scott; Rodean, Jonathan; Hall, Matt; Mendoza, Jason; Ahrens, Kym. (2024). Trends in Substance-Related Visits Among Youth to US Children's Hospitals, 2016-2021: An Analysis of the Pediatric Health Information System Database.. The Journal of adolescent health : official publication of the Society for Adolescent Medicine, 75(1), 76-84. https://doi.org/10.1016/j.jadohealth.2024.02.016
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