US Pediatric Fentanyl Exposures Surge Nearly 1200%

TOPLINE:

Nonfatal pediatric fentanyl exposures surged by almost 1200% between 2015 and 2023 in the United States and life-threatening effects increased by 180%, a new study showed.

METHODOLOGY:

• Researchers conducted a repeated cross-sectional study examining characteristics of nonfatal pediatric fentanyl exposures reported to poison centers in 49 US states between 2015 and 2023.
• The analysis included 3009 nonfatal pediatric fentanyl exposures (58% boys). 59% of patients were aged 13-19 years and 41% were aged 0-12 years.
• Data were obtained through the Researched Abuse, Diversion and Addiction-Related Surveillance System Poison Center Program.
• Fentanyl exposures were categorized by reason of exposure and route of fentanyl administration. Medical outcomes were categorized as none, mild (minimally bothersome effects), moderate (more pronounced or prolonged effects), and major (life-threatening or permanently disabling effects).

TAKEAWAY:

• The number of fentanyl exposures increased significantly from 69 cases in 2015 to 893 in 2023, representing a 1194% increase overall, a 924% increase among patients aged 0-12 years, and a 1506% increase among those aged 13-19 years (all P < .001).
• 82% of children aged 0-12 years were exposed unintentionally, whereas 66% of adolescents aged 13-19 years misused or abused fentanyl.
• Ingestion-only use was the predominant route of fentanyl administration and increased from 44% of exposures in 2015 to 68% in 2023 (P < .001), with a higher prevalence of ingestion-only use in the younger group than in the older group (77% vs 54%).
• Life-threatening effects increased from 16% in 2015 to 45% in 2023, representing a 179.6% increase (P < .001). Major medical outcomes were significantly associated with misuse/abuse (adjusted prevalence ratio [aPR], 1.51), ingestion-only use (aPR, 1.23), and exposures that occurred in the Northeast region (aPR, 1.35).

IN PRACTICE:

“Prevention and harm reduction efforts need to include efforts for youth, particularly as counterfeit pills containing fentanyl flood the illicit market. Parents or other individuals leaving fentanyl (licit or illicit) out in the open with unsupervised children can easily lead to pediatric exposure,” the investigators wrote.

Parents and healthcare providers should “be aware of the importance of receiving training about these drugs and what they do and what they look like, and how to caution teens about the dangers of friends and siblings sharing diverted drugs,” co-investigator Linda Cottler, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, Florida, said in a press release.

SOURCE:

The study was led by Joseph J. Palamar, NYU Grossman School of Medicine, New York. It was published online on March 7 in The American Journal of Drug and Alcohol Abuse.

LIMITATIONS:

Although Centers for Disease Control and Prevention mortality data include all or most fatal opioid-related exposures, poison centers capture only a portion of exposures. Researchers also noted a lack of systematic collection of nonfatal exposure data, and that most people who were exposed or overdosed did not contact poison centers. Additionally, the data lacked information regarding whether exposures were related to prescribed/medical use or exposure to illicitly manufactured fentanyl, and the specific form of the drug used was not recorded for different routes of administration. 

DISCLOSURES:

The study was supported by the National Institute on Drug Abuse of the National Institutes of Health. One investigator reported being a consultant for a federal reduction in drug trafficking program, and another reported being an employee of a nonprofit poison and drug safety organization. Full details are listed in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.