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Characterization of fentanyl exposures in children less than 10 years old

Danae Massengill1,2, Lynne Rosenberg1, Eli Forst2

  • 1Rocky Mountain Poison and Drug Safety, Denver Health, Denver, CO, USA.

Clinical Toxicology (Philadelphia, Pa.)
|February 19, 2026
PubMed

Insights

Illicit fentanyl exposure poses serious risks to young children, often causing respiratory and central nervous system depression. Prompt recognition and naloxone (Narcan) treatment are crucial for managing these pediatric fentanyl exposures.

Area of Science:

  • Pediatric Toxicology
  • Emergency Medicine
  • Public Health

Background:

  • Illicitly manufactured fentanyl is a growing concern in pediatric populations.
  • Limited data exists on the clinical course and management of fentanyl exposures in children.
  • This study addresses the need for better understanding of pediatric fentanyl toxicity.

Purpose of the Study:

  • To describe the clinical characteristics of fentanyl exposures in children under 10 years old.
  • To outline the management strategies and treatment outcomes for these pediatric cases.
  • To inform clinical practice and improve patient care for fentanyl-exposed children.

Main Methods:

  • Retrospective chart review at a single children's hospital.
  • Inclusion criteria: patients under 10 years old with confirmed fentanyl exposure (urine immunoassay or drug test).
  • Data collected: demographics, exposure source, symptoms, treatment, disposition, and outcomes.

Main Results:

  • 25 children (median age 14 months) were included.
  • Most symptomatic patients (92%) showed central nervous system depression, 88% respiratory depression.
  • 8 patients (31%) required CPR; 92% received naloxone (Narcan), with many needing multiple doses or infusions.

Conclusions:

  • Fentanyl exposures significantly impact young children, leading to severe symptoms like respiratory and CNS depression.
  • Almost all affected children required naloxone (Narcan) and hospital admission.
  • Early detection via fentanyl immunoassays and timely intervention, including naloxone (Narcan) prescription, are vital for managing pediatric fentanyl toxicity.
Abstract

Keywords:
Fentanylfentanyl immunoassaynaloxonepediatric poisoningsunintentional exposure

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