6196 Paediatric opioid poisoning in the UK. A retrospective analysis of clinical enquiries to the National poisons information service

Objectives To evaluate reported paediatric opioid poisoning cases in the UK between 2012 and 2021. Methods The National Poisons Information Service (NPIS) telephone enquiries database (UKPID) was searched for calls regarding opioid poisoning in children under 18-years in 2012 to 2021. The NPIS online clinical guidance database TOXBASE® was searched for accesses relating to opioids in the United Kingdom for both adults and children. The Office of National Statistics provided paediatric data for hospital admissions and deaths in those aged under 20 years-old due to opioids. Results From 2012 to 2021, there were 3,600 telephone enquiries to the NPIS in relation to opioid exposures regarding children under-18-years. Annual telephone enquiries regarding paediatric opiate poisoning reduced year on year, from around 450 to 300 calls/year. In the study period, there were 838,455 accesses to TOXBASE®. A rise in TOXBASE® annual accesses relating to opioids from 71, 642 in 2012 to 87,498 in 2021 was noted (figure 1). There has been a steady decrease in the total calls to the NPIS, with users preferring to use the app or online TOXBASE® service. This likely accounts for the apparent fall in NPIS enquiries matching our search criteria. Hospital admissions from opioid poisoning remained consistent, with around 1,500 admissions/year. Deaths were uncommon but averaged 17 deaths annually (figure 1). Co-codamol was the most reported substance to NPIS, with 1,315 calls (36.5%), followed by codeine with 940 (26.1%) with data for all opiates summarised in figure 2. Conclusion There is a general downward trend in telephone enquiries to NPIS, but many childhood exposures may have been dealt with through consultations via TOXBASE®, where overall accesses relating to opioids have increased. Although associated opiate toxicity death is uncommon, the rates appear unchanged over the decade. Opioid poisoning leading to hospital admission in the paediatric population is still worryingly common. Action is required at medical, social, political and economic levels to reduce opiate prescribing and harm to stop the UK following the devastating effect of the opioid epidemic that has been so harmful in North America