Think that unresponsive 4 year old is to young to be an opiate overdose? Think again. A recently published study in the Annals of Emergency Medicine found that 9,179 children were reported to poison control centers for opiate overdose between 2003 and 2006. That number represents some fraction of the true 
opiate overdoses seen by emergency providers in that time. One physician who coauthored the study felt it would be conservative to estimate the true number to be twice that high.
OK, lots of numbers, but how can we put that into perspective? Today, opiate overdose ranks second only to carbon monoxide poisoning as the most common culprit for pediatric overdose.
The most likely culprits for opiate overdose in kids were Hydrocodone and Oxycontin.
When you find that unresponsive 5 year old don’t forget to consider access to home medications. Look for open or accessible pill bottles, empty cups of medication and those plastic multi-medication dispensers so popular with grandmas and grandpas these days. Ask if family members or adults present take pain medications or Methadone. If they do, find out where those pills are located and check them out.
Consider the hallmark signs of opiate overdose. When you find a child with altered mental status, clammy skin and depressed respiration, think about opiates. Also remember those pupils. Pinpoint pupils can be a good tip off to opiates on board.
Glad i found this site. i am our services training officer and i am putting together an ist scenario.