Background: Prior research demonstrated the relationship between birth order and adolescent risky behavior. The possible connection between the presence of siblings and birth order and underage alcohol abuse is unknown. Methods: Our study involves 10 years of data collection on underage alcohol intoxication in Dutch hospitals. A total of 2,234 patients were included in the current study. Results: Adolescents treated for alcohol intoxication less often have no siblings (6.7%) than the population has (14.8%). Furthermore, middle and youngest children are overrepresented in the patient population. Conclusion: The presence of older siblings is a risk factor for acute alcohol intoxication.

Background This study aims to determine the prevalence of tobacco smoking and illicit drug use among Dutch adolescents admitted to hospital for acute alcohol intoxication treatment. Furthermore, socio-demographic predictors for smoking and illicit drug use in the sample population will be studied. The relationship between illicit drug use and specific characteristics of intoxication, such as blood alcohol concentration (BAC) and duration of reduced consciousness is also investigated. Methods The national Dutch Paediatric Surveillance Unit was used to prospectively register cases of acute alcohol intoxication from 2007 through 2017. Cases were included if they met the following inclusion criteria: BAC > 0.0 g/L, aged between 10 to 18 years old and requiring hospital treatment due to reduced consciousness. Questionnaires were sent to paediatricians to obtain clinical information. Results During the period 2007–2017, 5322 cases that met the inclusion criteria were reported. In this patient group, the prevalence of tobacco smoking was 22.2% (CI 21.0–23.5%), while the prevalence of illicit drug use was 11.8% (CI 10.9–12.7%). The predictors for smoking were the absence of alcohol-specific parental rule-setting, lower educational level, non-traditional family structure and positive drug screening. The predictors for illicit drug use were the absence of alcohol-specific parental rule-setting and smoking. Illicit drug use was also associated with a lower BAC at the time of admission. Conclusions Assessing smoking and illicit drug use among adolescents admitted for acute alcohol intoxication is important in acute cases of intoxication, for outpatient follow-up and for the purposes of prevention. The relationship between simultaneous illicit drug use and a lower BAC is of relevance for paediatricians’ attempts to diagnose acute intoxication. With respect to outpatient follow-up and preventive measures, it is important to be aware that adolescents’ alcohol consumption, tobacco and illicit drug use are related and, ultimately, increase the odds of using other substances.

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Adolescents with substance use disorders are often diagnosed with co-occurring mental disorders. However, it is unknown if adolescent hospital admission for acute alcohol intoxication is also associated with co-occurring mental disorders. Therefore, the primary aim of this study is to estimate the prevalence of co-occurring mental disorders among Dutch adolescents admitted for acute alcohol intoxication. Secondly, this study aims to explore the cross-sectional relationship between the co-occurrence of mental disorders and patient characteristics, such as sex, age and blood alcohol concentration at admittance. Data were retrospectively collected from 726 adolescents admitted for acute alcohol intoxication. Overall, 245 (34%) of the 726 adolescents treated for acute alcohol intoxication were diagnosed with a co-occurring mental health disorder, such as attention-deficit hyperactivity disorder (13%) or autism spectrum disorder (2.1%). Attention-deficit hyperactivity disorder in particular seems to be more prevalent in the study population than in the general Dutch adolescent population. Conclusion: This study demonstrates that among adolescents admitted for acute alcohol intoxication, the prevalence of co-occurring mental disorders is a common and a relevant issue for treatment and prevention strategies. What is Known:• Alcohol consumption among adolescents has been associated with negative psychosocial effect.• Among adolescents admitted for acute alcohol intoxication, risk factors for psychological dysfunction appear to be inadequately assessed, documented and followed up. What is New:• The current study reports on the prevalence of co-occurring mental disorders among a substantial sample of adolescents admitted for acute alcohol intoxication.• Understanding the prevalence of co-occurring mental disorders is clinically relevant for the outpatient follow-up of adolescents admitted for acute alcohol intoxication.

AimAlcohol intoxication in children and adolescents is a severe health concern in current paediatrics. In this longitudinal study we monitored intake and treatment of 5893 adolescents in Departments of Paediatrics in Dutch hospitals over the years 2007 to 2016.Methods from 2007 till 2016 we collected data on all adolescents (inclusion criteria: aged younger than 18 and with a positive blood alcohol concentration (BAC), treated by a paediatrician in all Dutch hospitals. Within the Dutch Paediatric Surveillance System (NSCK), all paediatricians report adolescents and fill in a questionnaire, making use of a patient interview.Results in total 5893 adolescents were treated, mainly (4,678; 88%) related to severe alcohol intoxication; mean age was 15.4 years, and 52% were boys. BAC level increased during this period (1.82 in 2007 and 2.01 in 2016), and reduced consciousness lasted from 2.24 hours in 2007 till 3.12 hours in 2016). 11.4% Of the adolescents with alcohol intoxication had simultaneous drug usage. The attitude of the parents changed during the years: in 2011 (first year of registration) 68% of the parents gave permission to their child to drink alcohol, in 2016 this decreased to only 19%.Conclusions alcohol intoxication treatment remains an issue of importance. This dataset enables us to conduct longitudinal and interesting analyses on alcohol intoxication characteristics in youngsters, medical treatment, and events leading up to the intoxication.