Emergency medical services calls rise among pre-teens for opioid exposures

Emergency medical services calls rise among pre-teens for opioid exposures | Image Credit: © Antonio Rodriguez - stock.adobe.com.

Emergency medical services (EMS) calls for opioid exposures among U.S. children are showing concerning trends, with steady increases in pre-teen cases over the past five years. The findings were presented at the American Academy of Pediatrics (AAP) 2025 National Conference & Exhibition, held September 26 to 30 in Denver, Colorado.^1,2

The study, EMS Calls for Pediatric Patients Ages 11-18 years with Opioid Exposures Using NEMSIS Data, examined emergency calls involving suspected opioid exposures among children and adolescents. Data were drawn from the National Emergency Medical Services Information System (NEMSIS), which collects EMS records nationwide.

“Opioid exposures in middle- and high school-aged students are a growing public health concern. The medical community and legislative authorities have an opportunity and obligation to enact policies to decrease risk to these vulnerable kids,” said study author Sonia Lam, DO, a pediatric emergency medicine fellow.

Methods

Researchers conducted a retrospective analysis of EMS data from 2019 through 2023. To identify cases of opioid exposure, investigators used International Classification of Diseases, Tenth Revision (ICD-10) codes for opioid-related complaints (F11 and T40) and included records where naloxone was administered.

Children were categorized into 2 groups: middle school (ages 11 to 13 years) and high school (ages 14 to 8 years). Outcomes evaluated included annual call trends, sex distribution, and acuity level, which was classified as lower acuity, emergent, critical, or deceased. Chi-square analysis was used to compare proportions, while linear regression evaluated trends over time.

Key findings

Among middle school children, EMS calls for opioid exposures increased each year, rising from 257 in 2019 to 560 in 2023. In contrast, calls for older adolescents rose from 3,904 in 2019 to 7,392 in 2022, before dropping to 6,960 in 2023.

Demographic and clinical differences were observed between groups:

• Sex distribution: In the middle school group, 61.1% of patients were female, whereas in the high school group, females comprised 40.6% of cases (p=0.001).
• Acuity: A higher proportion of pre-teens presented with critical illness (24.5%) compared with older adolescents (15.7%) (p=0.001).
• Overall trend: EMS calls for opioid exposures among middle school children showed a consistent upward trajectory, while calls among older adolescents peaked before declining.

Clinical and public health implications

The results highlight important differences in opioid exposure patterns between younger and older children. According to Lam, “The medical community and legislative authorities have an opportunity and obligation to enact policies to decrease risk to these vulnerable kids.”

The findings also suggest that prevention and treatment efforts should be tailored to age and sex-specific patterns of opioid exposure. “Younger children have a more persistent pattern of increasing calls over time, they are disproportionately female, and they are more likely to present with critical acuity than older children,” the authors concluded.

By underscoring the severity of opioid exposures in pre-teen children and identifying demographic differences between age groups, this study points to the need for targeted, evidence-based interventions. These may include education for families, school-based prevention programs, and community initiatives designed to reduce access to opioids among vulnerable youth populations.

The investigators emphasized that the growing number of EMS calls for pre-teens is a pressing concern that warrants both medical and policy-level responses. The data reinforce the importance of continued vigilance in monitoring opioid exposure trends and implementing preventive strategies aimed at safeguarding pediatric populations.

References:

1. American Academy of Pediatrics. Emergency calls for pediatric opioid exposure on rise: New research. Eurekalert. September 26, 2025. Accessed September 26, 2025. https://www.eurekalert.org/news-releases/1098728?
2. Lam S. EMS Calls for Pediatric Patients Ages 11-18 years with Opioid Exposures using NEMSIS data. Abstract. Presented at: American Academy of Pediatrics 2025 National Conference & Exhibition. September 26-30, 2025. Denver, Colorado.