US National Trends in Pediatric Deaths From Prescription and Illicit Opioids, 1999-2016

Abstract

Importance: It is not yet known how many children and adolescents die each year from opioid poisonings and how mortality rates have changed over time. Objective: To examine national trends in pediatric deaths from prescription and illicit opioids. Design, Setting, and Participants: Cross-sectional in which serial mortality data from the Centers for Disease Control and Prevention were analyzed. The population included 8986 children and adolescents (age, <20 years) who died in all US settings from opioid poisonings between 1999 and 2016. Data were collected and analyzed between June 1 and October 31, 2018. Exposures: All opioids. Main Outcomes and Measures: Age-specific mortality rates per 100 000 were estimated with smoothing spline Poisson regression. Results: Of the 8986 children and adolescents who died between 1999 and 2016 from prescription and illicit opioid poisonings, 6567 (73.1%) were male, 7921 (88.1%) were among adolescents aged 15 to 19 years, and 605 (6.7%) were among children aged 0 to 4 years. The overall pediatric mortality rate increased from 0.22 (95% CI, 0.19-0.25) to 0.81 (95% CI, 0.76-0.88) per 100 000, an increase of 268.2% (P for time effect