Connecticut Pediatric Opioid Poisoning Trends Surrounding the COVID-19 Pandemic

Opioids are common substances involved in poisonings with increasing rates in fentanyl-related mortality since 2014. The COVID-19 pandemic compromised school attendance and supervision, which may have increased the risk of opioid ingestions in children. Our objective was to evaluate pediatric opioid poisonings in Connecticut before and during the COVID-19 pandemic.

This cross-sectional retrospective study used emergency department (ED) discharges involving children aged 0-17 years captured in the Connecticut Injury Surveillance System. International Classification of Diseases, 10th Revision, Clinical Modification codes were used to identify discharges involving opioids (T40.0-T40.4, T40.60, T40.69, F11). The χ 2 test was used to identify differences by pre-COVID (2017-2019) and COVID (2020-2022) periods. Rates were examined by age, sex, race/ethnicity, insurance, and discharge status.

There were 1,386,796 ED discharges during the study period. Less than 1% involved opioid (N = 257) or fentanyl (N = 31) poisonings; no discharges were coded for both. The rate of opioid poisonings decreased 28.6%, from 2.1 to 1.5 per 10,000 ED visits. Subanalysis showed that the rate of fentanyl poisonings remained the same (0.2 per 10,000 ED visits). The rate of opioid poisonings was highest among non-Hispanic White children during both periods. However, there was a 57.7% increase in the rate of opioid poisonings in non-Hispanic Black children. The rate decreased for all other race/ethnic groups.

Results of our study showed a rise in opioid poisonings among non-Hispanic Black and elementary school-aged children during the COVID-19 pandemic. Future prevention efforts may choose to further investigate and understand the trends in the more vulnerable groups.