Suspected nonfatal stimulant overdoses are becoming more common among U.S. youth, a new study suggests. Researchers examined data on 89.5 million emergency department visits from April 2016 through September 2019 to identify trends in nonfatal overdoses in three age groups: 0 to 10 years, 11 to 14 years, and 15 to 24 years. Overall, the youngest group experienced an average of 22.3 suspected nonfatal overdoses per 10,000 emergency department visits, compared with 43.2 among youth 11 to 14 years old and 85.2 among youth 15 to 24 years old. Across the study period, the average quarterly change in rates of all nonfatal overdoses per 10,000 emergency department visits was +2.0% for youth under 10 years, and +2.3% for youth 11 to 14 years. For youth 15 to 24 years, there was an average quarterly decrease of 0.04% in the rate of nonfatal overdoses per 10,000 emergency department visits. For stimulants, the average quarterly increase in nonfatal overdoses was 3.3% for youth 10 and under, 4.0% for youth 11 to 14 years, and 2.3% for youth 15 to 24 years. "It was striking to see nonfatal stimulant overdoses among our youngest populations," said lead study author Douglas Roehler, an epidemiologist with the National Center for Injury Prevention and Control at the U.S. Centers for Disease Control and Prevention in Atlanta. "Stimulant prescribing has been on the rise among youth, and as more prescribed stimulants are in the public, there is greater potential for misuse among all populations," Roehler said by email. One bright spot in the findings is that nonfatal heroin overdoses became less common among teens and young adults, with an average quarterly decrease of 3.3% for youth 15 to 24 years old. "This mirrors decreasing declines in heroin-related deaths over the past few years, which may reflect the effectiveness of public health efforts," Roehler said. The findings underscore the importance of keeping prescription medications out of reach of children and teens, and of providing substance use treatment to youth who are treated in the emergency department for nonfatal overdoses, the study team concludes in Pediatrics. One limitation of the study is the lack of data on overdoses treated outside of the emergency department. Another is the potential for the data based on hospital billing codes to miss certain overdoses or to lack specific data on what drugs or combinations of drugs were involved. "The most serious drug overdose cases often involve multiple substances, especially opioids, and in particular, illicit fentanyl and its analogs," said Dr. Gary Smith, president of the Child Injury Prevention Alliance and director of the Center for Injury Research and Policy at Nationwide Children's Hospital in Columbus, Ohio. Still, the results underscore that clinicians need to educate patients and families about the dangers of substance use among adolescents and adults as well as the unintentional exposure among young children, Dr. Smith, who wasn't involved in the study, said by email. "They can also advocate for improved access to effective treatment for co-occurring mental health and substance use disorders," Dr. Smith said. (Editing by Christine Soares) —Lisa Rapaport Source
