OBJECTIVES There is little understanding of the circumstances behind fatal pediatric opioid poisonings. Our objective was to characterize opioid fatalities according to child, family, and household factors. METHODS We used data from the National Fatality Review-Case Reporting System to describe the circumstances behind the deaths of children 0 to 17 years of age who died of an opioid poisoning (ie, prescription opioid, heroin, illicit fentanyl) between 2004 and 2020. Decedents were stratified into age groups: 0-4, 5-9, 10-14, and 15-17 years. RESULTS The majority (65.3%) of the 1696 fatal opioid poisonings occurred in the child's own home. Prescription opioids contributed to 91.8% of deaths, heroin contributed to 5.4%, and illicit fentanyl to 7.7%. Co-poisonings with nonopioid substances occurred in 43.2% of deaths. Among 0- to 4-year-olds, 33.9% died of homicide and 45.0% had a primary caregiver with a history of substance use/abuse. Among 10- to 14-year-olds and 15- to 17-year-olds, respectively, 42.0% and 72.8% of decedents had a history of substance use/abuse. In each age group, at least 25.0% of children were victims of previous child maltreatment. CONCLUSIONS A history of maltreatment and substance use-whether on the part of the caregiver or the child-are common factors surrounding fatal pediatric opioid poisonings, the majority of which occur in the child's own home. Families with children of all ages would benefit from interventions focused on opioid prescribing, storage, disposal, and misuse. These findings also underscore the urgency of ensuring that access to naloxone becomes universal for families with a history of maltreatment and/or substance use.

中文翻译：

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2004-2020 年致命儿科阿片类药物中毒的情况。


目的 对致命的儿科阿片类药物中毒背后的情况知之甚少。我们的目标是根据儿童、家庭和家庭因素来描述阿片类药物死亡的特征。方法 我们使用来自全国死亡审查病例报告系统的数据来描述 2004 年至 2020 年间死于阿片类药物中毒（即处方阿片类药物、海洛因、非法芬太尼）的 0 至 17 岁儿童死亡背后的情况。死者分为年龄组： 0-4 、 5-9 、 10-14 和 15-17 岁。结果 1696 起致命的阿片类药物中毒事件中，大多数 （65.3%） 发生在儿童自己的家中。处方阿片类药物占 91.8% 的死亡，海洛因占 5.4%，非法芬太尼占 7.7%。与非阿片类物质混合中毒发生在 43.2% 的死亡中。在 0 至 4 岁的儿童中，33.9% 死于凶杀，45.0% 的主要照顾者有药物使用/滥用史。在 10 至 14 岁和 15 至 17 岁的青少年中，分别有 42.0% 和 72.8% 的死者有药物使用/滥用史。在每个年龄组中，至少有 25.0% 的儿童是以前虐待儿童的受害者。结论 虐待和药物使用史——无论是看护者还是儿童——是致命的小儿阿片类药物中毒的常见因素，其中大部分发生在儿童自己的家中。有各个年龄段孩子的家庭将受益于专注于阿片类药物处方、储存、处置和滥用的干预措施。这些发现还强调了确保有虐待和/或药物使用史的家庭普遍获得纳洛酮的紧迫性。