TABLE 2

Characteristics of the Confirmed Opioid-Related Adverse Events

Age, y
2–5, n = 566–11, n = 7112–17, n = 310All Ages, n = 437
Category of case, n (%)
 Probable, with symptoms33 (58.9)49 (69.0)190 (61.3)272 (62.2)
 Probable, with intervention6 (10.7)0 (0.0)21 (6.8)27 (6.2)
 Possible17 (30.4)22 (31.0)99 (31.9)138 (31.6)
Severity of outcome, n (%)
 Death1 (1.8)1 (1.4)1 (0.3)3 (0.7)
 Hospitalization or opioid-related intervention and/or care escalation6 (10.7)5 (7.0)71 (22.9)82 (18.8)
 ED visit onlya49 (87.5)65 (91.6)238 (76.7)352 (80.6)
Source of opioid,b n (%)
 Patient’s prescription54 (96.4)69 (97.2)264 (85.2)387 (88.6)
 Other source2 (3.6)1 (1.4)10 (3.2)13 (3.0)
 Source not indicatedc01 (1.4)36 (11.6)37 (8.5)
Circumstances of opioid use related to the adverse event,d n (%)
 Therapeutic use45 (80.4)67 (94.4)199 (64.2)311 (71.2)
 Unintentional overdose9 (16.1)3 (4.2)19 (6.1)31 (7.1)
 Abusee0036 (11.6)36 (8.2)
 Self-harm0035 (11.3)35 (8.0)
 Circumstances not indicated2 (3.6)1 (1.4)21 (6.8)24 (5.5)
Primary symptoms and/or signs of opioid toxicity,f n (%)
 Gastrointestinal19 (33.9)23 (32.4)92 (29.7)134 (30.7)
 Neuropsychiatric13 (23.2)13 (18.3)94 (30.3)120 (27.5)
 Dermatologic15 (26.8)21 (29.6)66 (21.3)102 (23.3)
 CNS depression9 (16.1)7 (9.9)81 (26.1)97 (22.2)
 Allergic10 (17.9)19 (26.8)48 (15.5)77 (17.6)
 Respiratory depression1 (1.8)011 (3.6)12 (2.8)
 Other05 (7.0)10 (3.2)15 (3.4)
  • These are confirmed cases from 1999 to 2011.

  • a In 337 patients, symptoms associated with opioid toxicity were determined to be the main reason for the ED visit. In 15 patients, there was another reason for the visit, but opioid toxicity was part of the encounter.

  • b The categories were mutually exclusive.

  • c Medical records did not indicate the source; however, all these patients filled prescriptions for opioids.

  • d The categories were mutually exclusive, on the basis of the following hierarchy: self-harm was greater than abuse, which was greater than unintentional overdose, which was greater than therapeutic use.

  • e Records with signs and/or symptoms of abuse and/or opioid withdrawal.

  • f Symptoms and signs were not mutually exclusive. See Supplemental Section 5 for lists of specific symptoms.