To the Editor: Opioid abuse by adults is widely perceived as a major health hazard in the United States of America (1, 2). From 1997 to 2012 hospitalizations attributed to opioid poisonings in children raised by nearly twofold (3). Further, Emergency Department (ED) visits by young children and adolescents for poisoning by prescription opioids is well described (4). However, current national estimates of opioid abuse by children who visit the ED for any cause are relatively unknown. Understanding and characterizing opioid abuse in children at a national level is the initial step in optimizing the overall care for children. In this initial exploratory study, we sought to estimate the burden of opioid dependence/abuse (OD/OA) in children who visited the ED for any cause in the United States. We hypothesize that there is an increasing trend of OD/OA in children who visited the ED during the study period.

We performed a retrospective analysis of the Nationwide Emergency Department Sample (NEDS) (5) for the years 2008–2013. The NEDS is the largest all-payer ED database in the United States. Discharge data for ED visits from nearly 945 hospitals located across major states in the USA, approximating a 20% stratified sample of US hospital-based EDs are available in NEDS. Weighted, NEDS contains estimates of roughly 135 million ED visits. All ED visits with ICD-9-CM diagnoses codes for OD/OA (304.00-03; 305.50-53) among those aged up to 21 years were selected. Demographic characteristics of this cohort were examined. Multivaraiable linear and logistic regression models were used to examine ED charges and disposition status following the ED visit.

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