research summary

Opioids Are the Most Frequent Substance in Pediatric Poisoning Fatalities

Leigh Precopio

Opioids were the most frequent cause of fatal pediatric poisonings among children aged 5 years or younger within the United States, according to the results of a recent study.

The researchers utilized the National Fatality Review-Case Reporting System to examine data from 40 states from 2005 to 2018 on death from poisoning among infants and young children. Demographic, supervisor, death investigation, and substance-related variables were analyzed. A total of 731 poison-related fatalities were included.

The results indicated that 42.1% (308 of 731) of poisoning-related fatalities occurred among infants aged less than 1 year. Death occurred in the child’s home in 65.1% (444 of 631) of cases with available data, and 16.6% (97 of 581) of children had an open child protective services case at the time of death. Further, 32.1% (203 of 631) of children were being supervised by an individual other than the biological parent at time of death.

Opioids were the most common substance leading to death at 47.3% (346 of 731) of cases. Over-the-counter pain, cold, and allergy medications were the second most commonly used substance at 14.8% (108 of 731) of cases. The rate of opioids as the contributor to these poisoning fatalities increased over the period examined, accounting for 24.1% (7 of 29) of deaths in 2005 and 52.2% (24 of 46) of deaths in 2018.

“As the landscape of the opioid crisis evolves, the development of pediatric-specific opioid response initiatives should be prioritized,” the researchers noted.

Limitations of the child death review process are also limitations to this study, including jurisdictional protocols, availability of resources, and interpretation of variables.

“Opioids were the most common substances contributing to fatal poisonings among young children,” the researchers concluded. “Over-the-counter medications continue to account for pediatric fatalities even after regulatory changes. These data highlight the importance of tailored prevention measures to further reduce fatal child poisonings.”



Gaw CE, Curry AE, Osterhoudt KC, Wood JN, Corwin DJ. Characteristics of fatal poisonings among infants and young children in the United States. Pediatrics. 2023;151(4):e2022050916. doi:10.15411/peds.2022-059016.