Adolescent exposures to traditional and novel psychoactive drugs, reported to National Poison Data System (NPDS), 2007–2017

Background: Survey data on adolescent drug use trends have limitations evaluating the impact of drug use on health and may lag current trends. The objective was to describe National Poison Data System (NPDS) trends, medical outcomes, and healthcare encounters from adolescent exposures of traditional and novel psychoactive drugs. Methods: Retrospective review of adolescent (10–18 years of age) exposure calls to all U.S. poison centers, from January 1, 2007 through December 31, 2017, using generic codes for traditional and novel psychoactive drugs. Descriptive statistics and univariate Poisson regression modeling were used for analysis. Results: There were 49,757 exposure calls for the included psychoactive drugs. The median age was 16 years (IQR 15,17), 64% were male, and the majority were evaluated in a healthcare facility (92%). Marijuana had the most exposure calls (36.6%), followed by synthetic cannabinoids (e.g., spice; 21.3%). There were 181 (<1%) deaths; the highest fatality rates were from fentanyl, 2C drugs (phenylethylamine derivatives), and heroin. LSD exposure calls have had the most significant increase over the past 10 years. Conclusion: U.S. Poison Centers reported almost 50,000 exposure calls and 181 deaths over 10 years for adolescent exposures of both traditional and novel psychoactive drugs, demonstrating the significant health impact on this vulnerable population. Opioids and 2C drugs contributed to the highest mortality rates, moderate/major symptoms and healthcare utilization, and LSD had the most significant increase in calls. Multi-source surveillance methodology is critical in understanding the public health impact on drug abuse in the adolescent population.