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TOPLINE:

The number of visits to the emergency department (ED) for nonfatal opioid overdoses remained stable from 2010 to 2022 among adolescents, with more than a quarter of cases resulting in revisits within a year and mental health conditions reported as the primary reason for return visits.

METHODOLOGY:

• Researchers conducted a retrospective cohort study to investigate trends in ED visits related to nonfatal opioid overdoses among adolescents.
• They analyzed data from a pediatric health database that contained administrative records from 45 tertiary care pediatric hospitals across 27 US states and Washington, DC.
• The analysis included adolescents aged 12-17 years who presented to the ED with a nonfatal opioid overdose; the principal diagnosis of opioid overdose was defined using standard diagnostic codes.
• The primary outcome was a revisit to the ED within 1 year of the initial overdose.

TAKEAWAY:

• Of the 1874 ED visits for nonfatal opioid overdoses by adolescents (median age, 16 years; 61.6% girls), 79.4% were attributed to prescription opioids; nearly half the participants were discharged from the ED and did not require further hospitalization or observation.
• The incidence of ED visits for opioid overdoses remained stable from 2010 to 2022 (incidence rate ratio, 0.999; 95% CI, 0.981-1.017), despite a temporary elevation in 2014.
• A little over one quarter (n = 516) of patients revisited to the ED within 1 year, with 39.3% of these visits coded for mental health conditions.
• Among the participants with ED revisits for opioid overdose (4.8%; n = 25), more than three quarters were either admitted to the hospital or placed under observation.

IN PRACTICE:

“The largest frequency of revisits with a measured condition were related to a mental health complaint, highlighting the need to ensure that appropriate services for both substance misuse and other mental health conditions are consistently provided at these visits,” the authors of the study wrote.

SOURCE:

This study was led by Michael S. Toce, MD, MS, of the Boston Children’s Hospital in Boston. It was published online on April 24, 2025, in Journal of Adolescent Health.

LIMITATIONS:

This study focused on urban and highly populated areas. The use of diagnostic codes limited the examination of underlying factors associated with overdoses, such as self-harm or recreational use.

DISCLOSURES:

This study was supported by the Institutional Centers for Clinical and Translational Research Population Science Pilot Grant from the Harvard Medical School. The authors reported having no relevant financial interests.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.