COCAINE can show up in the most unexpected places. Recently, at Children's Hospital of Michigan in Detroit, the emergency department found cocaine metabolite in the urine of more than 5% of the toddlers and children treated there for routine pediatric complaints (Am J Dis Child. 1991;145:1430-1432). The most likely route of exposure, the researchers suggest, is second-hand smoke inhaled when adult caretakers use freebase or crack cocaine.
The physiological and behavioral effects of chronic environmental exposure to cocaine in children are not well established. There have been several cases reported in the scientific literature of cocaine toxicity in children exposed to crack smoke. Two had transient neurological symptoms such as drowsiness and unsteady gait, and three had seizures that laboratory tests could not explain (Am J Dis Child. 1989;143:25-27 and 1990;144:743-744).
Some studies in adult animals have suggested a "kindling" phenomenon, in which the central nervous system becomes more sensitive