Emergency department visits by pediatric patients for poisoning by prescription opioids

Abstract

Background Prescription medication abuse is an increasingly recognized problem in the United States. As more opioids are being prescribed and abused by adults, there is an increased risk of both accidental and intentional exposure to children and adolescents. The impact of pediatric exposures to prescription pain pills has not been well studied. Objectives We sought to evaluate emergency department (ED) visits for poisoning by prescription opioids in pediatric patients. Methods This retrospective study looked at clinical and demographic data from the Nationwide Emergency Department Sample (NEDS) from 2006 – 2012. Results There were 21,928 pediatric ED visits for prescription opioid poisonings and more than half were unintentional. There was a bimodal age distribution of patients with slightly more than half occurring in females. The majority of patients were discharged from the ED. More visits in the younger age group (0–5 years) were unintentional while the majority of visits in the adolescent age group (15–17 years) were intentional. Mean charge per discharge was $1,840 and $14,235 for admissions and surmounted to over $81 million in total charges. Conclusion Poisonings by prescription opioids largely impact both young children and adolescents. These findings can be used to help target this population for future preventive efforts.

Overdose Risk in Young Children of Women Prescribed Opioids

“…Roughly 65% of all acute poison exposures reported to Poison Information Centers involve preschool children and are largely preventable. Rising rates of unintentional pediatric poisonings are strongly correlated with the increased use of adult drugs, dominated by prescription medications, 19 and are associated with increased health care use, including emergency department visits 20 and hospitalizations. 21,22 Campaigns, such as the Centers for Disease Control and Prevention's "Up and Away" initiative, 23 have the goal of reducing unintentional exposures among young children through parental education about safe medication handling and storage.…”

Prescription Opioid Exposures Among Children and Adolescents in the United States: 2000–2015

“…From 2006 to 2012, >22 000 children were treated in US emergency departments for opioid poisoning. 5 The annual rate of opioid poisoning-related hospitalization increased by 165% from 1997 to 2012. 6 Opioid exposures at even relatively low doses can result in life-threatening effects in children.…”

“…16 -18 Although multiple studies have described the epidemiology of opioid overdose 10 -12, 19 and misuse 12,14 in the United States, little research has been published examining opioid poisoning among children, particularly those aged <6 years old. Three studies on opioid poisoning among children included only individuals treated in emergency departments 5,20 or those who were hospitalized. 6 Other research has focused on pediatric poisoning fatalities.…”

Opioid abuse in children: an emerging public health crisis in the United States!

“…From 1997 to 2012 hospitalizations attributed to opioid poisonings in children raised by nearly twofold (3). Further, Emergency Department (ED) visits by young children and adolescents for poisoning by prescription opioids is well described (4). However, current national estimates of opioid abuse by children who visit the ED for any cause are relatively unknown.…”

“…Limitations of the present study include the use of administrative data set with the potential for underestimating the actual problem. Nevertheless, the utility of NEDS for exploratory studies is well established (3)(4)(5). Clear guidelines are lacking pertaining to the testing of OA in children in various medical settings.…”