UMEM Educational Pearls


Substance use disorder contributes significantly to pediatric exposure/poisoning. There has been an increase in the opioid overdose deaths in the US, placing pediatric population to possible exposure. A retrospective study of fatal pediatric poisoning in the US was investigated using the National Violent Death Reporting System (NVDRS) from 2012-2017.

17 US states (AK, CO, GA, KT, MD, MA, NJ, NM, NC, OH, OK, OR, RI, SC, UT, VA, WI) reported to NVDRS from 2012-2017.   

Age was limited to 0-9 years



1850 violent deaths were identified: n=122 (7%) were poisoning related



  • Male: 49%
  • Approximately 25% were homicide-suicides


  • Midwest: 25%
  • Northeast: 5%
  • South: 53%
  • West: 17%

Most common exposure/etiology

  1. Opioid (50%)
  2. Benzodiazepines (8%)
  3. Amphetamines (7%)
  4. Antidepressants (5%)


  • A large proportion of poisoning related pediatric fatality was due to opioid exposure
  • Largest proportion of death was reported from the Southern US.


Hunter AA et a. An examination of fatal child poisonings in the United States using the National Violent Death Reporting System (NVDRS), 2012–2017. Clin Toxicol. 2021