Emergency calls for pediatric opioid exposure on rise: New research

DENVER — Years after the opioid epidemic began in the mid-1990s, emergency medical services are seeing increases in emergency calls for pre-teens and adolescents, according to research presented during the American Academy of Pediatrics 2025 National Conference & Exhibition at the Colorado Convention Center from Sept. 26-30.

The research, “EMS Calls for Pediatric Patients Ages 11-18 years with Opioid Exposures using NEMSIS data,” examined calls for services due to suspected pediatric opioid exposure reported to the National Emergency Medical Services Information System, which tracks emergency medical service data from across the United States. Authors reviewed the data from 2019 through 2023, breaking it down into two categories: middle school aged children and high school aged teens.

Opioid exposure calls increased nationally each year of the study for middle-school aged children, rising from 255 calls in 2019 to 553 in 2023. Teenagers fared slightly better with drops in emergency opioid exposure calls after 2022.

Research author Sonia Lam, DO and pediatric emergency medicine fellow, said the new opioid exposure trends are causing concern among health professionals.

“Opioid exposures in middle- and-high school aged students are a growing public health concern. The medical community and legislative authorities have an opportunity and obligation to enact policies to decrease risk to these vulnerable kids,” Dr. Lam said.

Dr. Lam said that demographics varied by group, with females outnumbering males in the middle school age group, while the reverse pattern was true for the older group. Younger children also tend to present with significantly higher levels of acuity compared to older children

Authors suggest that targeted interventions for prevention of drug use disorders in children should be informed by how use varies with children’s age and sex.

The authors did not receive financial support for this research.

Dr. Lam is scheduled to present the research, which is below, from 2:15 p.m. to 2:30 p.m. MDT on Friday, Sept. 26, in the Colorado Convention Center, Meeting Room 108/110/112. To request an interview with the authors, contact Brianna Mortensen at BMortensen@salud.unm.edu.  

In addition, Dr. Lam will be among highlighted abstract authors who will give a brief presentation and be available for interviews during a press conference from noon-1:30 p.m. MDT Saturday, Sept. 27, in the National Conference Press Room, CCC 705/707. During the meeting, you may reach AAP media relations staff at 303-228-8338. 

Please note: only the abstract is being presented at the meeting. In some cases, the researcher may have more data available to share with media, or may be preparing a longer article for submission to a journal. 

# # #

The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org. Reporters can access the meeting program and other relevant meeting information through the AAP meeting website at http://www.aapexperience.org/

Program Name: 2025 Call for Abstracts

Submission Type: Section on Emergency Medicine

Abstract Title: EMS Calls for Pediatric Patients Ages 11-18 years with Opioid Exposures using NEMSIS data

Sonia Lam

The opioid crisis has long been an issue nationwide with the use of prescription opioids and heroin for pain management and recreational use. Poisoning, including drug overdose, is now the 3rd leading cause of death in U.S. children ages 1 to 19 years, after firearm injury and motor vehicle crashes. The purpose of this study is to compare the trend of opioid exposures among children in two age groups: pre-teenage, and teenage.

This retrospective study uses the National Emergency Medical Services Information System (NEMSIS) data set from the years 2019 to 2023. NEMSIS is a national system used to collect, store and share EMS data. To identify opioid exposures, the NEMSIS database includes ICD-10 codes for chief complaint (subsets of external cause codes F11 and T40) and whether naloxone was administered. Age groups were categorized as middle school (11-13 years) and high school (14–18 years). The two groups were compared for trends over time, sex ratio, and acuity level (lower acuity, emergent, critical, or deceased). Chi-square analysis compared proportions, and linear regression is used for trend analysis.

EMS calls for opioid exposure increased every year among 11–13-year-olds, from 257 in 2019 to 560 in 2023. Among 14–18-year-olds, numbers increased from 2019 (3,904) through 2022 (7,392), then decreased (6,960). In Figure 1, we present the proportion of overall EMS calls for each age group for opioid related complaints based on number of NEMSIS calls increased each year. The majority of patients in the middle school group were female (61.1%), while in the high school group, females were a minority of patients (40.6%) (p=0.001). Acuity level also varied by age group (p=0.001). In five years, there were acuity data for 1,429 calls in the middle school group and 21,340 in the high school group. A higher proportion of the middle school group presented as critical (24.5%) than the older age group (15.7%) (p=0.001) (Figure 2).

Patterns of EMS calls for middle school and high school children vary significantly. Younger children have a more persistent pattern of increasing calls over time, they are disproportionately female, and they are more likely to present with critical acuity than older children. These differences suggest targeted interventions for prevention and treatment of drug use disorders in children.

Figure 1. Rate of opioid calls per total number of calls by age group and year, NEMSIS data, 2019-2023. To compare the rate of change over time between the two age groups on one graph, we used the number of total NEMSIS calls for all reasons for each age group by year to calculate an annual rate by age group and year.

Figure 2: Acuity level on EMS Presentation.