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Passive freebase cocaine ('crack') inhalation by infants and toddlers
1Department of Pediatrics, College of Physicians and Surgeons, Columbia University, New York.
Insights
Children exposed to crack cocaine smoke by caretakers showed cocaine and benzoyl ecgonine in urine. This passive exposure may cause neurological symptoms like drowsiness, unsteady gait, and seizures in children.
Area of Science:
- Toxicology
- Pediatrics
- Environmental Health
Background:
- Cocaine abuse, particularly freebase (crack) cocaine, poses risks to vulnerable populations.
- Children may be exposed to environmental toxins through adult caretakers' substance abuse.
Observation:
- Four hospitalized children had cocaine and its metabolite, benzoyl ecgonine, detected in their urine.
- These children were exposed to crack cocaine smoke from adult caretakers.
- Two children experienced transient neurological symptoms, including drowsiness and unsteady gait.
- Two other children suffered seizures of undetermined etiology.
Findings:
- Passive inhalation of crack cocaine smoke led to detectable levels of cocaine and benzoyl ecgonine in children's urine.
- Neurological symptoms and seizures in these children may be linked to passive cocaine exposure.
- Laboratory investigations could not identify other causes for the observed seizures.
Implications:
- Children in households with crack cocaine abuse are at risk of cocaine toxicity through passive inhalation.
- Pediatricians and healthcare providers should consider environmental cocaine exposure in children presenting with unexplained neurological symptoms.
- Public health initiatives should address the risks of secondhand smoke exposure to illicit drugs in children.
Abstract:
Cocaine and its principal metabolite, benzoyl ecgonine, were isolated from the urine of four hospitalized children who had been exposed to the smoke of freebase cocaine ("crack") used by their adult caretakers. Two of the children had transient neurological symptoms (drowsiness and unsteady gait) and two had seizures whose cause could not be determined by laboratory investigation. Passive cocaine inhalation may have caused or contributed to these symptoms. Children in the care of adults who abuse freebase cocaine should be considered at risk not only for disruption of their social environment but also for the effects of cocaine toxicity.