• Thomas H Chun, Anthony Spirito, Lynn Hernández, Anne M Fairlie, Holly Sindelar-Manning, Cheryl A Eaton, and William J Lewander.
• Departments of Emergency Medicine and Pediatrics, The Alpert Medical School of Brown University, Providence, RI, USA. Thomas_Chun@brown.edu
• Acad Emerg Med. 2010 Jan 1; 17 (1): 63-71.

ObjectivesThe objective was to determine if adolescents presenting to a pediatric emergency department (PED) for an alcohol-related event requiring medical care differ in terms of substance use, behavioral and mental health problems, peer relationships, and parental monitoring based on their history of marijuana use.MethodsThis was a cross-sectional comparison of adolescents 13-17 years old, with evidence of recent alcohol use, presenting to a PED with a self-reported history of marijuana use. Assessment tools included the Adolescent Drinking Inventory, Adolescent Drinking Questionnaire, Young Adult Drinking and Driving Questionnaire, Center for Epidemiologic Studies Depression Scale, Behavioral Assessment System for Children, and Peer Substance Use and Tolerance of Substance Use Scale.ResultsCompared to adolescents using alcohol only (AO), adolescents who use alcohol and marijuana (A+M) have higher rates of smoking (F = 23.62) and binge drinking (F = 11.56), consume more drinks per sitting (F = 9.03), have more externalizing behavior problems (F = 12.53), and report both greater peer tolerance of substance use (F = 12.99) and lower parental monitoring (F = 7.12).ConclusionsAdolescents who use A+M report greater substance use and more risk factors for substance abuse than AO-using adolescents. Screening for a history of marijuana use may be important when treating adolescents presenting with an alcohol-related event. A+M co-use may identify a high-risk population, which may have important implications for ED clinicians in the care of these patients, providing parental guidance, and planning follow-up care.(c) 2010 by the Society for Academic Emergency Medicine.

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