There’s an increase in young people being diagnosed with opioid dependence or addiction in emergency departments, but this may just be the tip of the iceberg.

When it comes to age, the opioid epidemic doesn’t discriminate.

Even among teens and young adults.

A new study has concluded that the number of young people who were diagnosed at an emergency department with opioid dependence or addiction is on the rise.

The study data doesn’t include young people with an opioid problem who never visit the emergency room, so it’s just a glimpse at the overall reach of the epidemic.

“How big is the problem? That we don’t know. My suspicion is that we are just skimming the top,” said Dr. Veerajalandhar Allareddy, one of the study’s authors and medical director of the pediatric intensive care unit at the University of Iowa Stead Family Children’s Hospital.

Researchers discovered that the number of people nationwide age 21 years or younger who were diagnosed with opioid dependence or addiction rose from 32,235 in 2008 to 49,626 in 2013.

This amounts to about 135 young people each day testing positive for opioid dependence or addiction in 2013 — including prescription pain medications and illegal drugs such as heroin.

The increase over the seven years of the study may also be partially due to improved drug screening practices in emergency departments.

More than 88 percent of these visits were by 18- to 21-year-olds. Slightly more than 8 percent were by 16-year-olds and 17-year-olds.

Slightly more than half of these patients were males.

The majority of young people diagnosed at the emergency room with opioid dependence or addiction didn’t have other long-term health problems.

“We saw that about 92 percent of the kids did not have a comorbid condition,” Allareddy told Healthline, “which means the reason why they came to the [emergency room] was because of some sort of acute issue.”

This could be a broken arm, a cut that needed stitches, or even an ear infection.

Allareddy said that while some young people might tell the emergency room doctor that they have an opioid problem, it’s “unlikely.”

This means that it’s up to doctors to identify young people who need more help, rather than just treating the illness or injury that brought them to the hospital.

“When any kid walks into the [emergency room],” said Allareddy, “the physician should always have in mind: What is the possibility that this kid can have an underlying opioid problem?”

If needed, a doctor can do a thorough medical history and physical exam. Urine or other tests can help confirm opioid misuse.

The study will be presented Monday during the American Academy of Pediatrics 2017 National Conference & Exhibition in Chicago.

They study hasn’t yet been published in a peer-reviewed journal.

The study looked at only young people who showed up in the emergency department and were diagnosed with opioid dependence or addiction.

Some may have slipped through, either because the doctor didn’t screen them or the screening didn’t detect a problem with opioids.

Even more young people may be diagnosed by their primary care doctor, at an urgent care facility, or when admitted to a hospital for another medical condition.

“Once we start screening kids in the other service lines, the number of children who are dependent on opioids probably is very high,” said Allareddy.

And there are those young people who aren’t diagnosed at all and who continue misusing opioids for months or years without any help.

According to the National Institute on Drug Abuse (NIDA), about 4 percent of adults aged 18 to 25 used prescription opioids for nonmedical reasons during the past month. And almost 3 percent of 12- to 17-year-olds did.

NIDA also reports that almost 2 percent of adults aged 18 to 25 have ever used the opioid heroin, with 0.1 percent of 12- to 17-year-olds doing so.

Not all young people who misuse opioids become dependent or addicted.

But by staying alert to the possibility, emergency doctors can get young people with a real problem the help they need.

“[Emergency room] physicians have a huge role to play because they can try to hook up the kid with the inpatient service and get an opioid abuse specialist onboard,” said Allareddy.

“Or if the kid is stable enough, the doctor can try to ensure that the kid is being followed as an outpatient, and is getting the care needed to treat their opioid abuse.”