**1. Introduction**

216 Complementary Pediatrics

Ybarra, M. L., Espelage, D. L., & Mitchell, K. J. (2007b). The co-occurrence of Internet

1), S31-41. doi: 10.1016/j.jadohealth.2007.09.010

harassment and unwanted sexual solicitation victimization and perpetration: Associations with psychosocial indicators. *Journal of Adolescent Health, 41*(6 Suppl

> Misuse of alcohol has become a pediatric health care issue during the last decade. In clinical practice, patients are first treated in an acute care setting. After sobering up, follow-up treatment starts in an outpatient department. To cope with the increasing numbers of underage patients with alcohol intoxication, special programs have been developed to improve follow-up treatment of these patients. The focus has shifted towards underlying neuropsychological and social problems. The main goals of the program are behavioral changes and prevention of new events.

> The physiology of alcohol metabolism is clear, however in children and adolescents definitions of binge-drinking, problematic alcohol use and alcohol abuse are overlapping. Research is being done on epidemiology, risk factors and consequences that should be cleared up further. In particular, concerns about brain damage in young adolescents are a topic of interest.

> Besides medical attention being paid to this new patient group, policymakers should increase awareness of the dangers of alcohol use. National and international policies differ substantially in legal drinking age and location of purchase. Media attention and marketing also have a huge influence on the drinking behavior of adolescents.

This chapter deals with the following subjects:


A New Approach in Adolescent Alcohol Intoxication –

**3. Epidemiology** 

alcohol every month.

**4. Questionnaire content** 

Clinical Pediatric Experience and Research Combined 219

Symptoms of alcohol intoxication usually appear at a blood alcohol concentration of 20-50 mg/dl (0.2-0.5%) (Table 3). However, interpersonal variability can be observed. Children have a smaller extracellular volume and could therefore experience symptoms at a lower

Of all the substances, alcohol is –by far- the most popular product. Almost all secondary school students try out alcoholic beverages at least once before they leave school between the age of 16 and 18. The percentage of students who abstain in their secondary school period is constant at around 10% (ref). Between 50% and 60% of all students consume

Over the past years, this percentage has been rather stable. Since 2003, the youngest students (12 – 14 years) show an increase in lifetime prevalence of alcohol use and previous month alcohol use, especially among girls. Girls also seem to become an increasing cause of concern on other scales. Since 2003, young girls (<15 years) engage in binge drinking more

Monitoring alcohol related hospital admissions in the Netherlands is part of the Dutch Pediatric Surveillance System (NSCK). This unique and effective signaling system collects information on several predetermined diseases, disorders or symptoms in Dutch general and academic hospitals. Nearly all the Dutch pediatricians participate (92%). Adolescent alcohol use was included in 2007, and ever since it has been one of the leading topics of the system.

When a patient under the age of 18 is admitted because of alcohol related problems, the pediatrician in charge reports the case. Questionnaires are distributed to the pediatricians by mail or they can download them from the website. The questionnaire consists of four parts, exploring (1) previous alcohol use circumstances and hospital treatment, (2) patient

Time frame of intoxication (morning [6 a.m.–noon], afternoon [noon–6 p.m.], evening [6 p.m.–midnight], night [midnight–6 a.m.]), reason for hospitalization (traffic accident, other accident, aggression/violence, suicide attempt, reduced consciousness—if yes, period of unconsciousness in hours), blood alcohol concentration (BAC, grams of alcohol per liter blood), type of alcohol consumed (beer, wine, distilled spirits, premixed drinks, post mixed drinks [home-mixed or commercially mixed drinks], other), alcohol-obtaining practice (at home, from friends, supermarket, liquor store, hotel and catering industry, other), alcoholconsuming location (parents' home, adolescents' own home, friends' home, on the street, work place, at [a] school [party], public place [sports bar/canteen], commercial place [hotel and catering industry/bar/pub/discotheque], holiday, other), alcohol-consuming company (nobody, friends, parents, other relatives, strangers, other), and other (illicit) substances used (none, cannabis, cocaine, amphetamines / speed, magic mushrooms, Ecstasy, other). If respondents answered "yes" to the last question, method of confirmation was recorded

blood concentration. Symptoms of alcohol use will be further discussed below.

often and have the same frequency of drunkenness as young boys (3;4).

characteristics, (3) alcohol use patterns, and (4) control variables.

**4.1 Intoxication and characteristics of hospital treatment** 
