Evaluation of drug-endangered children: The yield of toxicology and skeletal survey screening

Howell, Sabrie; Bailey, Laurie; Coffman, Jamye

doi:10.1016/j.chiabu.2019.104081

Cited by 7 publications

(3 citation statements)

References 30 publications

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“…Our study found that encounters with positive cannabis tests had fewer CPS case openings and out-of-home placements than other drug types. Prior literature has shown an overlap of parental illicit drug use and child maltreatment; however, those studies do not isolate cannabis from other illicit drug ingestions and are limited in their ability to provide insight into the association between caregiver cannabis use and child maltreatment . There remains a need to establish cannabis-specific recommendations for approaching CPS reporting decision-making.…”

Section: Discussionmentioning

confidence: 99%

“…Prior literature has shown an overlap of parental illicit drug use and child maltreatment; however, those studies do not isolate cannabis from other illicit drug ingestions and are limited in JAMA Network Open | Pediatrics their ability to provide insight into the association between caregiver cannabis use and child maltreatment. [55][56][57] There remains a need to establish cannabis-specific recommendations for approaching CPS reporting decision-making. Our study results were mixed with regards to the association of race and ethnicity and insurance status with reporting practices.…”

Section: Oct-decmentioning

confidence: 99%

“…Child Protection System Outcomes for Children With Positive Urine Drug Screens their ability to provide insight into the association between caregiver cannabis use and child maltreatment. [55][56][57] There remains a need to establish cannabis-specific recommendations for approaching CPS reporting decision-making. Our study results were mixed with regards to the association of race and ethnicity and insurance status with reporting practices.…”

Section: Jama Network Open | Pediatricsmentioning

confidence: 99%

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Child Protection System Interactions for Children With Positive Urine Screens for Illicit Drugs

Rebbe,

Malicki,

Siddiqi

et al. 2024

JAMA Netw Open

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ImportanceYoung children are ingesting illicit drugs at increased rates, but it is unknown what the associated child protection system (CPS) responses are when a child tests positive.ObjectiveTo document the child protection system involvement and the characteristics of children who test positive for illicit substances.Design, Setting, and ParticipantsThis retrospective cross-sectional study linked medical discharge and child protection system administrative data. The setting was Rady Children’s Hospital San Diego, a free-standing pediatric hospital in California. Participants included all emergency department and inpatient medical encounters involving children aged 12 years or younger with a positive urine drug test between 2016 and 2021. Statistical analysis was performed from February 2023 to January 2024.ExposureDrug type, including amphetamines, barbiturates, benzodiazepines, cannabis, cocaine, fentanyl, opiates, and phencyclidine.Main Measures and OutcomesCPS responses associated with the medical encounter including reports, substantiations, case openings, and out-of-home placements.ResultsA total of 511 emergency department and inpatient medical encounters involving children had a positive drug test (262 [51.3%] were female; 309 [60.5%] were age 6 years or younger; fewer than 10 [&lt;3.0%] were American Indian or Alaska Native; 252 [49.3%] were Hispanic [any race], 20 [3.9%] were non-Hispanic Asian, 56 [11.0%] were non-Hispanic Black, 143 [28.0%] were non-Hispanic White, 36 [7.0%] had other or unknown race and ethnicity; 233 [43.6%] had a CPS report prior to the medical encounter). Following the positive screen, 244 (47.7%) were reported to child protection, and 61 (11.9%) were placed out-of-home within 30 days. Mean (SD) quarterly counts of encounters with positive drug tests doubled after the COVID-19 pandemic onset (32.9 [9.8]) compared with prior to the pandemic onset (16.5 [4.7]); for encounters positive for cannabis, mean (SD) quarterly counts were 3 times as high after the pandemic onset than prior (16.6 [4.7] vs 5.7 [2.9]). Encounters for children under age 1 were significantly more likely to have associated child protection reports (relative risk [RR], 2.91 [95% CI, 2.21-3.83]) and child protection case openings (RR, 1.71 [95% CI, 1.07-2.72]) than encounters involving older children.Conclusions and RelevanceIn this cross-sectional study of emergency department and inpatient medical encounters, less than half of children with positive urine drug screens were reported to CPS; out-of-home placements were uncommon. With increased encounters for positive drug tests, it is unclear what services these children and families are receiving.

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Section: Discussionmentioning

confidence: 99%

Section: Oct-decmentioning

confidence: 99%

Section: Jama Network Open | Pediatricsmentioning

confidence: 99%

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Child Protection System Interactions for Children With Positive Urine Screens for Illicit Drugs

Rebbe,

Malicki,

Siddiqi

et al. 2024

JAMA Netw Open

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“Don't Close the Door on Them”: Recruiting and retaining vulnerable Black adolescents in prevention research

Powell

Willis

Smith

et al. 2021

Journal Community Psychology

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There is a need to understand why some strategies work better than others for engaging vulnerable Black adolescents in prevention research, especially those who are affected by parental drug use. The current study sought to fill this gap. Thirty in-depth interviews were conducted with parents who reported a history of illicit drug use (N = 11), young adults who had a biological parent with a history of illicit drug use (N = 14), and service providers who work with families affected by illicit drug use (N = 5). Nearly all participants were Black and lived or worked in Baltimore, Maryland. Over half of the participants were female (62%). Interviews were recorded and ranged from 30 to 92 minutes in length. Data were analyzed using an inductive, content analysis approach. Four themes emerged (coined STAR): SAFE people and places minimize retraumatization; TEAMING UP with community partners increases acceptability; ADDRESSING a range of needs helps adolescents survive; and RELATABLE facilitators understand and listen to adolescents. Findings build onto and extend previous research that highlights strategies to This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

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Radiology in Suspected Child Abuse

Rijn

Nievelstein

Robben

2023

Forensic Aspects of Paediatric Fractures

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Evaluation of drug-endangered children: The yield of toxicology and skeletal survey screening

Cited by 7 publications

References 30 publications

Child Protection System Interactions for Children With Positive Urine Screens for Illicit Drugs

Child Protection System Interactions for Children With Positive Urine Screens for Illicit Drugs

“Don't Close the Door on Them”: Recruiting and retaining vulnerable Black adolescents in prevention research

Radiology in Suspected Child Abuse

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