Pediatric Emergency Medicine Fellow Ann & Robert H. Lurie Children's Hospital of Chicago Chicago, Illinois, United States
Background: Youth opioid-related overdose deaths have been increasing in recent years. Current surveillance systems rely on death certificates for mortality data and health facility-based diagnosis codes for non-fatal overdoses, both of which may underestimate the impact of the overdose epidemic among youth. Using a national prehospital database to identify fatal and non-fatal overdoses may facilitate a more comprehensive understanding of the burden, characteristics, and trends of youth opioid overdoses. Objective: To characterize and trend Emergency Medical Services (EMS) encounters for opioid overdoses among youth. Design/Methods: We performed a retrospective serial cross-sectional study of EMS encounters for opioid overdoses among youth ( < 25 years) from 2018-2022 using the National EMS Information System (NEMSIS) database. Overdose cases were identified if there was an ICD-10 code for opioid poisoning included as a symptom or provider impression or if there was receipt of naloxone with a positive response. We described sociodemographic and encounter characteristics. We trended overdose frequencies per 100,000 youth EMS encounters, overall and by age group. Results: We identified 149,898 encounters for youth opioid overdoses. Overdoses were most common among the 18-24 year age group, among males, and at private residences. At least one naloxone dose was administered at 65.6% of encounters (Table 1). The overall overdose encounter frequency was 985 per 100,000 youth EMS encounters. Annual overdose frequency increased from 777 per 100,000 youth EMS encounters in 2018 to 1,210 per 100,000 youth EMS encounters in 2020, then declined to 928 per 100,000 youth EMS encounters in 2022. From 2020 to 2022, overdose encounter frequencies remained stable among the 0-4 and 5-11 year age groups, decreased among the 18-24 year age group, and increased among the 12-17-year age group (Figure 1).
Conclusion(s): Youth EMS encounters for opioid overdoses peaked in 2020 before declining in 2021 and 2022. Adolescents 12-17 years were the only age group with overdose frequencies that remained elevated compared to 2020 levels, representing a potential emerging high-risk population. Studies utilizing prehospital data contribute to a comprehensive assessment of the youth opioid epidemic that will inform public health prevention strategies.
