Characteristics of Cases of Prescription Fentanyl Exposure Among US Children Aged <6 Years Reported to Poison Centers, 2012-2024.

OBJECTIVES

Illicit fentanyl exposure among US children has increased in the past 10 years. However, whether rates of prescription fentanyl exposure have changed in this population is unknown. We described prescription fentanyl exposure among young children.

METHODS

We studied cases of prescription fentanyl exposure among children aged <6 years that were reported to the National Poison Data System (NPDS) from 2012 through 2024. We described the characteristics of prescription fentanyl exposure and US geographic patterns. We used binomial tests, the Pearson χ2 test, and joinpoint trend analysis with a type I error rate of .05 as the threshold for significance.

RESULTS

From 2012 through 2024, a total of 376 cases of prescription fentanyl exposure among children aged <6 years were reported to NPDS. Boys (n = 179; 47.6%) and girls (n = 196; 52.1%) were equally represented (P = .48). Significantly more children aged <2 years than aged 2 to 6 years in our study group had prescription fentanyl exposure (61.5%; P < .001), and the most common formulation was transdermal patch (n = 202; 53.7%). Joinpoint trend analysis showed a slight but not significant increase in prescription fentanyl exposure among children aged <6 years from 2012 through 2015. However, from 2015 through 2024, prescription fentanyl exposure significantly decreased (annual percentage change = -7.9; P < .05). The state with the highest annual exposure rate from prescription fentanyl was Vermont (4.3 per 1 million population).

CONCLUSIONS

From 2015 through 2024, during a time of increasing exposure to illicit fentanyl, prescription fentanyl exposure among children aged <6 years decreased. Safe disposal of transdermal patches is important, and caregiver education is needed to prevent serious medical outcomes.