Trends in Pediatric Opioid Ingestion and Associated Factors in Washington State, 2014-2023

OBJECTIVES: Opioid intoxication among children is a growing public health concern given the increased prevalence of high-potency synthetic opioids in the United States. This study evaluated trends in pediatric opioid ingestions and associated demographic factors in Washington State. METHODS: We conducted a retrospective data review of Washington Poison Center nontherapeutic pediatric opioid exposures reported from January 2014 through December 2023 among children and adolescents aged 0 to 17 years. We assessed trends based on opioid type and demographic factors. We performed logistic regression analysis and calculated odds ratios (ORs) and 95% CIs. RESULTS: A total of 2873 pediatric opioid ingestions were reported; the mean (range) age was 7.4 (0.1-17.0) years, with a slight female predominance (52%). During the 10-year study period, we found a significant increase in fentanyl ingestion (9700%), a 59% decrease in hydrocodone ingestion, and a 56% decrease in oxycodone ingestion. Fentanyl ingestion (OR = 4.25; 95% CI, 2.88-6.22), adolescent age (OR = 2.00; 95% CI, 1.48-2.70), and a high-level neighborhood socioeconomic disadvantage (OR = 1.91; 95% CI, 1.36-2.73) had increased odds of a major effect (life threatening). We found 9 reported associated deaths. CONCLUSIONS: Recent trends of pediatric opioid ingestion in Washington State indicate a disproportionate increase in fentanyl ingestion and life-threatening effects associated with socioeconomically disadvantaged neighborhoods. Further studies and policy are needed to improve surveillance and prevention of pediatric opioid ingestions.