Trends in Emergency Department Visits for Nonfatal Opioid Overdoses Among Adolescents

Opioid-related deaths are increasing among adolescents. An improved understanding of emergency department (ED) visits for nonfatal opioid overdoses may inform treatment strategies to prevent subsequent morbidity and mortality. The objective of this study was to investigate trends in ED visits for nonfatal opioid overdoses among adolescents and assess rates and characteristics of 1-year ED revisits.

We performed a retrospective cohort study of the Pediatric Health Information System database involving adolescent (12-17 years) nonfatal opioid overdoses between January 2010 and December 2022. The primary outcome was 1-year ED revisit after nonfatal opioid overdose. Opioid overdose trends were assessed using a negative binomial regression model.

There were 1,874 ED visits for nonfatal opioid overdoses by adolescents. The majority (79.4%) of these were attributed to prescription opioids. Visits for opioid overdoses were stable over the course of the study period, with 32.7 and 30.3 opioid overdoses per 100,000 ED visits in 2010 and 2022 (incidence rate ratio 0.999 [95% confidence interval 0.981-1.017]), respectively. There were 516 (27.5%) visits associated with an ED revisit. Among these, 203 (39.3%) were for a mental health condition, 98 (19.0%) related to a traumatic injury, and 25 (4.8%) for a repeat opioid overdose.

ED visits for nonfatal opioid overdoses have remained stable among adolescents. The most commonly documented indication for revisits were due to a mental health complaint, highlighting the need to ensure that appropriate mental health services and referrals are consistently provided at these visits.