Toxicology-confirmed drug exposure in Brazilian children: a case series from a Poison Center

Drug use affects a significant portion of the Brazilian population, which increases the likelihood of children being exposed to illicit drug environments, making them a particularly vulnerable group. This study describes the profile of illicit drug exposure in children up to 12 years in Rio Grande do Sul state, Brazil, based on emergency cases. Data were collected from suspected intoxication cases attended between 2018 and 2023 in children ≤12 years old. Urine samples were analyzed for cocaine and its metabolites, THC-COOH, and amphetamine-type stimulants using LC-MS/MS. Information about the cases was also collected. Of 286 suspected cases, 32.9% detected at least one illicit drug. Cocaine and its metabolites were the most common (24.8%), followed by THC-COOH (9.4%) and MDA/MDMA (2.1%). Among detected drug cases, 56.4% were male. The mean age was 3.4 ± 3.5 years, with the highest incidence in 1 to 4-year-olds (47.9%). Exposure circumstances included accidental (37.2%), mistreatment/violence (8.5%), and abuse (2.1%). Most exposures occurred at home (58.5%). A notable prevalence of illicit drugs, mainly cocaine, was found. These data show a worrying scenario of drug exposure, primarily involving children aged 1 to 4 years. Above all, it also demonstrates a high frequency of exposure to illicit drugs in their own homes. The findings provide a solid basis for toxicovigilance activities and the development of public health policies aimed at protecting the vulnerable pediatric population.