At least 1,200 children are admitted to Welsh A&E departments for alcohol and drug abuse each year, new research has found.
The figures, obtained by BBC Wales, show more than 800 children have attended casualty every year for the past three years to be treated for alcohol abuse. Some such children are claimed to be as young as four.
Hundreds more patients under 16 have been seen after taking drugs – whether that be as a result of accidental swallowing of tablets, medication overdose or substance abuse.
Dr Richard Lewis, Welsh Secretary of the British Medical Association told BBC Wales the year-on-year increases in A&E attendance among children was "increasingly worrying".
"I think it's pretty well recognised by health services and health professionals that there's an increasing problem with both alcohol and drug-related incidents with younger and younger people," he said.
"We see year-on-year increases with attendances at A&E departments, particularly for alcohol."
Keith Towler, Children's Commissioner for Wales, told BBC Wales the figures did not come as a surprise and called for a shifting in general attitudes towards alcohol as a way of combating this issue.
Towler cited the Welsh Government's latest wellbeing monitor, published earlier this year, which showed people under 20 account for almost 10% of all referrals for treatment for alcohol problems in Wales to further emphasise his growing concerns.
"The long-term dangers of alcohol and drug misuse are well documented, and more and more young people now understand the health risks associated with excessive drinking and are, in fact, choosing to avoid alcohol," he said.
"But if we want to successfully combat this problem I think we need to shift society's general attitudes towards alcohol."
Welsh Government figures for 2008-09 showed more than 120 children under the age of 12 in Wales were referred for specialist help for drug and alcohol problems.