We report the emergence of a new group of substances of abuse in the USA, known as bath salts, with quantitative results in 18 patients. State and federal authorities used timely information from poison centers on the bath salt outbreak during investigations to help track the extent of use and the effects occurring from these new drugs. Close collaboration between state authorities and poison centers enhanced a rapid response, including legislation.

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This study suggests significant neurologic toxicity from tramadol overdose. Serious cardiovascular toxicity was not seen.

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OBJECTIVES: This study analyzes and compares exposures to prescription opioids among children and adolescents younger than 20 years old in the United States. METHODS:Data from the National Poison Data System for 2000 through 2015 were analyzed. RESULTS:Poison control centers received reports of 188 468 prescription opioid exposures among children aged <20 years old from 2000 through 2015. The annual number and rate of exposures increased early in the study period, but declined after 2009, except for buprenorphine exposures, which increased during the last 3 study years. Hydrocodone accounted for the largest proportion of exposures (28.7%), and 47.1% of children exposed to buprenorphine were admitted to a health care facility (HCF). The odds of being admitted to an HCF were higher for teenagers than for children aged 0 to 5 years (odds ratio [OR]: 2.86; 95% confidence interval [CI]: 2.78-2.94) or children aged 6 to 12 years (OR: 6.62; 95% CI: 6.06-7.02). Teenagers also had greater odds of serious medical outcomes than did children aged 0 to 5 years (OR: 3.03; 95% CI: 2.92-3.15) or children aged 6 to 12 years (OR: 4.59; 95% CI: 4.21-5.00). The rate of prescription opioid-related suspected suicides among teenagers increased by 52.7% during the study period.CONCLUSIONS: Prescription opioid-related HCF admissions and serious medical outcomes were higher among teenagers. Contrary to trends for other prescription opioids, exposures to buprenorphine have increased in recent years; children aged 0 to 5 years accounted for almost 90% of buprenorphine exposures. These findings indicate that additional prevention efforts are needed.