Exposures to Opioids Among Wisconsin Children and Adolescents, 2002-2016

Opioid overdoses and opioid-related fatalities have increased dramatically in Wisconsin over the past decade. The observed rise in morbidity and mortality parallels increased opioid prescribing and greater use of illicit drugs such as heroin. Increased availability of both prescription and illicit opioids may increase the risk of exposure and overdose among the pediatric population.

We examined demographics and temporal trends in opioid exposures among children aged 0-19 years using hospital encounter and Wisconsin Poison Control Center (WPC) data. Exposures were categorized by type of opioid.

We identified 3,320 WPC calls and 2,725 hospital encounters involving opioids during 2002-2016. Within the hospital encounter data, the rate of opioid-involved exposures increased significantly in children aged 0-5 years and adolescents aged 13-19 years. The majority of opioid-related hospital encounters involved prescription opioids. However, the proportion of hospital encounters involving heroin increased significantly among 13-19 year olds from 2002-2016. Within WPC data, the proportion of calls involving tramadol increased among 0-5 year olds and 13-19 year olds. However, calls about opioid/acetaminophen combinations decreased significantly as a proportion of opioid exposures.

These findings suggest the need for caregiver education regarding safe storage and disposal of prescription opioids to prevent unintentional or intentional exposure to these substances among young children and adolescents. Overdose rates among teens continue to rise and an increasing proportion are due to heroin; comprehensive treatment and prevention strategies targeting this demographic are needed.