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Pediatric Cocaine Abuse Follow-up

  • Author: Anthony J Weekes, MD, RDMS, RDCS; Chief Editor: Caroly Pataki, MD  more...
 
Updated: Apr 14, 2016
 

Further Outpatient Care

Close medical follow-up is important for any comorbid conditions (eg, sexually transmitted diseases and HIV counseling and testing).

Refer to a behavioral and developmental pediatric specialist, if available.

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Further Inpatient Care

Admit patients who have any of the major toxicologic complications of cocaine use or when inpatient drug counseling is deemed necessary.

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Deterrence/Prevention

Predicting whether a given adolescent will experiment with drugs is difficult, as is determining which individuals who experiment will proceed to abuse or dependence. Parents can lessen the chance of a child or adolescent developing a substance abuse problem by providing positive role modeling, open communication, and education on the nature and dangers of drug use. Children who abuse drugs have increased risk for involvement in crime, violence, and unprotected sex and its attendant consequences. Such involvement negatively impacts not only the individual but also family, friends and acquaintances, and society as a whole. Risk factors for developing a drug problem include the following:

  • Depression
  • Low self-esteem
  • Family history of substance abuse

Early recognition of warning signs and intervention are crucial to avert a serious drug habit. Parents should be made aware that these findings might suggest other problems and indicate the need for referral to a primary care physician and a child and adolescent psychiatrist. Warning signs include the following:

  • School - Drop in performance and/or interest, increase in absences, problems with discipline
  • Social - Change in friendships, fewer prosocial activities, problems with police
  • Emotional - Withdrawal, mood swings, very argumentative behavior, depressed state, low self-esteem, irresponsibility, apathy, poor judgment
  • Physical - Weight loss, fatigue, frequent ailments, glazed/red eyes
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Complications

Parents should be made aware that early warning signs listed above might suggest other problems. Referral to a primary care physician to exclude medical causes is recommended. A more encompassing evaluation by a child and adolescent psychiatrist is then indicated.

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Patient Education

Provide patients with information about the serious dangers cocaine use poses to their health, and present a candid picture of cocaine's effects on their psychosocial functioning.

Discuss the high risk of relapse and the efforts necessary to combat relapse.

Adolescents are more receptive to nonjudgmental discussions. Address an adolescent's sense of immortality by emphasizing the powerful dangers of cocaine and addiction.

Behavioral and developmental pediatric specialists serve an important role in dealing with the volatile and/or difficult to understand child or adolescent.

For excellent patient education resources, see eMedicineHealth's patient education articles Cocaine Abuse, Drug Dependence and Abuse, and Substance Abuse.

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Contributor Information and Disclosures
Author

Anthony J Weekes, MD, RDMS, RDCS Ultrasound Fellowship Director, Associate Director of Emergency Ultrasound, Department of Emergency Medicine, Carolinas Medical Center

Anthony J Weekes, MD, RDMS, RDCS is a member of the following medical societies: American College of Emergency Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Coauthor(s)

Douglas S Lee, MD Attending Physician, Department of Emergency Medicine, Naples Community Hospital

Douglas S Lee, MD is a member of the following medical societies: American Academy of Emergency Medicine

Disclosure: Nothing to disclose.

Specialty Editor Board

Mary L Windle, PharmD Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Chief Editor

Caroly Pataki, MD Health Sciences Clinical Professor of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, David Geffen School of Medicine

Caroly Pataki, MD is a member of the following medical societies: American Academy of Child and Adolescent Psychiatry, New York Academy of Sciences, Physicians for Social Responsibility

Disclosure: Nothing to disclose.

Additional Contributors

Chet Johnson, MD Professor of Pediatrics, Associate Director and Developmental-Behavioral Pediatrician, KU Center for Child Health and Development, Shiefelbusch Institute for Life Span Studies; Assistant Dean, Faculty Affairs and Development, University of Kansas School of Medicine

Chet Johnson, MD is a member of the following medical societies: American Academy of Pediatrics

Disclosure: Nothing to disclose.

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