Adolescent emergency department presentations with alcohol- or other drug-related problems in Perth, Western Australia

Aims. To identify the morbidity, type of substance used and the pattern of presentation by adolescents with problems related to alcohol or other drug (AOD) use. Design. A 4-week retrospective review of hospital records. Setti ng. Four metropolitan hospitals in Perth, Australia. Participants. There we re 1064 presentations by people aged 12-19 years of which 160 (15%) were re lated to AOD use. The median age of the AOD cases was 17 (interquartile ran ge 16-19) of whom 97 (61%) were male and 19 (12%) were Indigenous Australia ns. Findings. Alcohol was the most frequent precursor to presentation (66, 41%) followed by heroin (24, 15%) and prescription/over-the-counter drugs ( 24, 15%). Injury was the most common diagnosis at presentation (50, 31%), f ollowed by overdose/drug use (47, 29%). A diagnosis of injury was significa ntly more likely following the use of alcohol than other categories of subs tances (chi (2) = 42.07, df = 3, p<0.001). Deliberate self-harm (DSH) occur red in more female than male cases (<chi>(2) = 7.4, df = 1, p<0.01). Presen tations were more frequent over the weekend (102, 64%) than on weekdays, an d the length of stay was significantly shorter for weekend cases (Mann-Whit ney U 2132, p<0.05). Conclusions. Given the small window of opportunity to provide AOD treatment to youth following hospital presentation, a number of suggestions are made. From a harm-minimization perspective the focus of in terventions should be on alcohol use by male youth and DSH associated with prescription/over-the-counter drug use by female adolescents. In addition, Indigenous youth are over-represented in hospital presentations, but there is currently a lack of evaluated interventions designed for them.