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Background <p>Despite the opioid crisis being declared a national emergency in 2017, few studies have examined disparities in overdose mortality trends among children and adolescents. This study assessed trends in opioid-involved overdose mortality among U.S. individuals aged 0 to 19&#xa0;years, categorized by age, sex, race/ethnicity, census region, opioid type (prescription, synthetic, and heroin), and county rural/urban designation, from 1999 to 2019.</p> Methods <p>Mortality data were sourced from the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research Database. Opioid-related deaths were identified using ICD-10 codes. Crude and age-adjusted mortality rates (AAMR) were assessed by age, sex, race/ethnicity, census region, opioid type, and county rural/urban designation. Temporal trends were analyzed using Joinpoint regression to estimate annual percentage changes (APC) and average APC. 95% confidence intervals were derived using the Empirical Quantile method and the Parametric Method.</p> Results <p>Between 1999 and 2019, 10,799 children and adolescents died from opioid overdoses (AAMR = 0.6 per 100,000; 95% CI: 0.6–0.6). From 2013–2019, overall mortality increased by 4.5% annually (95% CI: 0.91, 15.54). Mortality trends increased among Non-Hispanic Black (APC = 7.84; 95% CI: 5.12–10.56) and Hispanic individuals (APC = 5.29; 95% CI: 2.84–7.74) from 1999 to 2019, while remaining stable among Non-Hispanic White individuals from 2004 to 2019 (APC = -0.69; 95% CI: -2.09 to 0.58). Mortality rates also increased in the Northeast from 1999 to 2019 (APC = 4.23; 95% CI: 2.70–5.78) and in the West from 2015 to 2019 (APC = 21.96; 95% CI: 13.50–39.67), with a sharp increase in deaths involving synthetic opioids from 2014 to 2019 (APC = 43.37; 95% CI: 21.13–120.46).</p> Conclusions <p>Opioid overdose mortality trends among US children and adolescents have increased in recent years. Contemporary rises are most pronounced among Non-Hispanic Black and Hispanic children, in the Northeastern and Western regions, and from synthetic opioids. The disparities in opioid-related deaths underscores the need for targeted interventions and continued&#xa0; research to inform public health strategies.</p>

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Racial/Ethnic and Regional Disparities in Opioid-Involved Overdose Deaths among Children and Adolescents in the United States

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2025年7月24日

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  • Greta Muriel Eikermann,
  • Can Martin Ludeke,
  • Annika Eyth,
  • Aline M. Grimm,
  • Tina Ramishvili,
  • Felix Borngaesser,
  • Maira Rudolph,
  • Nicole Aber,
  • Corinne M. Kyriacou,
  • Giselle D. Jaconia,
  • Jerry Chao,
  • Ibraheem M. Karaye

摘要

Background

Despite the opioid crisis being declared a national emergency in 2017, few studies have examined disparities in overdose mortality trends among children and adolescents. This study assessed trends in opioid-involved overdose mortality among U.S. individuals aged 0 to 19 years, categorized by age, sex, race/ethnicity, census region, opioid type (prescription, synthetic, and heroin), and county rural/urban designation, from 1999 to 2019.

Methods

Mortality data were sourced from the Centers for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research Database. Opioid-related deaths were identified using ICD-10 codes. Crude and age-adjusted mortality rates (AAMR) were assessed by age, sex, race/ethnicity, census region, opioid type, and county rural/urban designation. Temporal trends were analyzed using Joinpoint regression to estimate annual percentage changes (APC) and average APC. 95% confidence intervals were derived using the Empirical Quantile method and the Parametric Method.

Results

Between 1999 and 2019, 10,799 children and adolescents died from opioid overdoses (AAMR = 0.6 per 100,000; 95% CI: 0.6–0.6). From 2013–2019, overall mortality increased by 4.5% annually (95% CI: 0.91, 15.54). Mortality trends increased among Non-Hispanic Black (APC = 7.84; 95% CI: 5.12–10.56) and Hispanic individuals (APC = 5.29; 95% CI: 2.84–7.74) from 1999 to 2019, while remaining stable among Non-Hispanic White individuals from 2004 to 2019 (APC = -0.69; 95% CI: -2.09 to 0.58). Mortality rates also increased in the Northeast from 1999 to 2019 (APC = 4.23; 95% CI: 2.70–5.78) and in the West from 2015 to 2019 (APC = 21.96; 95% CI: 13.50–39.67), with a sharp increase in deaths involving synthetic opioids from 2014 to 2019 (APC = 43.37; 95% CI: 21.13–120.46).

Conclusions

Opioid overdose mortality trends among US children and adolescents have increased in recent years. Contemporary rises are most pronounced among Non-Hispanic Black and Hispanic children, in the Northeastern and Western regions, and from synthetic opioids. The disparities in opioid-related deaths underscores the need for targeted interventions and continued  research to inform public health strategies.