Introduction Concerns have been raised about the increasing presentation of children and young people (CYP) to the Emergency Departments (EDs) having taken recreational drugs or alcohol.

Aims The aims of this study are to estimate the proportion of drug and alcohol-related presentations to a large ED and to identify associated patient and presentation characteristics.

Methods A retrospective analysis of patients aged 12–18 years attending a large ED from January 2012–December 2012 was carried out. Characteristics of all presentations related to alcohol and recreational drug use were recorded.

Results 167 patients were included in the study. 35% of patients were under 16 years of age, over 50% were female and over half of the presentations were at night or weekends. 51% presented with an altered level of consciousness, other presentations included respiratory or circulatory compromise, agitation, vomiting and injuries. Alcohol was the commonest substance taken seen in over three quarters of presentations, 38% had taken illegal drugs and 18.5% admitted to taking both drug and alcohol. 78% presented to the ED via an ambulance. Investigations were performed in approximately half of the patients and included CT (0.5%), ECG (23%), blood tests (22%) and urine toxicology (4.3%). More than two-thirds did not receive any treatment but 16% of those attending the ED were admitted, mainly because of the effects of alcohol. 49% of admitted patients were under 16 years of age.

Conclusion The number and presentations of alcohol and drug related attendances present a risk to CYP and is a burden to the ED and paediatric inpatient services. Effective intervention and preventative strategies are needed to reduce drug and alcohol related behaviour and co- morbidity.