ORIGINAL RESEARCH article
Front. Toxicol.
Sec. Clinical Toxicology
Invisible Victims: Rising Pediatric Cocaine Exposures in France (2020–2024) – Insights from the National Poison Center Database
Provisionally accepted
- 1Aix Marseille Univ, APHM, Institut de Neurosciences de la Timone, UMR7289 CNRS, Hop Sainte Marguerite, Department of Clinical Pharmacology, CAP-TV, 13005, Marseille, France., Assistance Publique Hôpitaux de Marseille, Marseille, France
- 2APHM, Hop Sainte Marguerite, Service de Pharmacologie Clinique, CAP-TV, Marseille, France, Assistance Publique Hôpitaux de Marseille, Marseille, France
Select one of your emails
You have multiple emails registered with Frontiers:
Notify me on publication
Please enter your email address:
If you already have an account, please login
You don't have a Frontiers account ? You can register here
Background: Cocaine use remains prevalent in Europe and has been associated with pediatric exposures through accidental ingestion, passive inhalation, and perinatal or postnatal transmission, potentially leading to significant toxicity in young children. Objective: This study aimed to quantify the number of pediatric cocaine exposures for which consultation with a French poison center was requested, characterize clinical presentations and severity, evaluate medical interventions and outcomes, and assess child protection service involvement. Methods: We conducted a retrospective observational study of children aged 0–10 years with suspected or confirmed cocaine exposure reported to French Poison Centers from January 1, 2020, to December 31, 2024. Data collected included demographics, exposure route, clinical manifestations, toxicological analyses, treatments, outcomes, and Poisoning Severity Score (PSS). Results: A total of 113 suspected pediatric exposures were identified, of which 76 (67%) were confirmed by toxicological analysis. Median age was 1.8 years, and 63 children were younger than 3 years. Exposure routes included intrauterine exposure (n=7), breastfeeding (n=12), ingestion (n=9), and inhalation (n=1). Most cases were symptomatic, with 25 minor (PSS 1), 24 moderate (PSS 2), and 8 severe cases (PSS 3), one fatality (PSS 4). No consistent association between measured cocaine or metabolite concentrations and clinical severity was observed in the limited number of cases with quantitative data (n=15). Supportive care was sufficient in most cases, while 17 children required specific medical interventions. Conclusion: Pediatric cocaine exposures represent a significant clinical and public health concern, occurring through multiple pathways without predictable dose-response relationships. Clinical assessment must be guided by physical examination rather than quantitative toxicology alone. Prevention efforts must target households with substance use disorders.
Keywords: Blood analysis, breastfeeding, Children, Cocaine, intoxication
Received: 25 Oct 2025; Accepted: 12 Feb 2026.
Copyright: © 2026 von Fabeck, Glaizal, Schmitt, Torrents and Simon. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Katharina von Fabeck
Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.