P3.141: Rates of Naloxone Administration in a Pediatric Patient Population Throughout the COVID-19 Pandemic

Background: The coinciding COVID-19 pandemic has caused an exacerbation in the opioid epidemic. Currently, there is limited research regarding the effects of the COVID-19 pandemic on the trends of opioid overdoses and naloxone administration in the young pediatric population. With increases in adult opioid use during the pandemic, it is likely that pediatric populations experienced similar exposures, resulting in increased naloxone administrations. This study reports changes in rates of naloxone administration before and during the COVID-19 pandemic. Additional data collected allows for the identification of trends in demographics for those with accidental exposure to opioids.

Methods: We conducted a retrospective chart review study of pediatric patients under the age of 10 years, who were admitted to our hospital from 2013 to 2023 and had received naloxone, including those transferred to the hospital. Data evaluated included patient demographics, transfer status, place of naloxone administration, number of naloxone doses, total naloxone doses, history of chronic disease, history of prematurity, need for intubation, type of exposure, and parental employment and marital status. Data comparisons were performed using Kruskal–Wallis tests with significance established at p< 0.05.

Results: A total of 52 patients were included in our study with n=12 (23.1%) in the pre-COVID, n=22 (42.3%) in the early COVID, and n=18 (34.6%) in the late COVID groups. Of patients receiving naloxone, n=35 (67.3%) were males and n=17 (32.7%) were females. There was no significant difference in the number of doses, total non-infusion/infusion, and total overall dose of naloxone given among groups. Patients in early and late pandemic groups had a higher percentage of Medicaid insurance (86.4% and 72.2%, respectively) as compared to the 50% in the pre-pandemic group (p=0.02). When compared to patients with non-opioid exposure, a higher percentage of patients with opioid exposure were transferred to our hospital (p=0.04), identified as Black (p=0.04), and were given infusions of naloxone (p=0.007). Age on admission varied significantly between patients with opioid exposure (1 month-4 years old) compared to those with non-opioids exposure (1-7 years old) (p < 0.001). There was no significant difference in the type of exposure among the different COVID-19 periods.

Conclusion: Naloxone administration in the young pediatric population has increased during the pandemic, with the highest percentage seen during the early pandemic. Patients that were more likely to receive treatment for opioid overdose were less than 4 years of age, identified as Black, were transferred from outside institutions, and received infusions of naloxone. Through this research and further exploration of these trends, there is potential to decrease accidental opioid overdoses and related injuries in at-risk pediatric patients.