Pediatric Opioid Exposure on the Rise

US Poison Control Centers have been plagued with more than 188,000 calls regarding pediatric exposure to opioids from 2000 to 2015, according to a new study published by Pediatrics. This translates to approximately 1 call every 45 minutes.

Due to outreach efforts, opioid use has been decreasing since 2009. Unfortunately, pediatric exposure to buprenorphine, which is used to treat opioid use disorder, has continued to climb. Approximately 47% of these young patients are admitted to a healthcare facility as a result of opioid exposure, which highlights the need for increased preventative initiatives, according to the study authors.

"As physicians, we need to find a balance between making sure that we are helping our patients manage their pain, and making sure we don't prescribe more or stronger medication than they need," said senior study author Gary Smith, MD, DrPH. "While overall rates of exposure to opioids among children are going down, they are still too high. We need to continue to examine our prescription practices and to increase education to parents about safe ways to store these medications at home to keep them out of the hands of children."

In the study, the investigators gathered data from the National Poison Data System. Included in the data were information about the product, route of exposure, individual exposed, why they were exposed, and other useful information.

Approximately 60% of the exposures reported to poison control occurred among patients younger than age 5, while 30% were teenagers. Hydrocodone, oxycodone, and codeine exposure were responsible for a majority of calls. The authors reported that the severity and reason for exposure varied by age.

Among children age 5 and younger, exposures mostly occurred at home, and were able to be treated without serious adverse events. In this population, exposures were typically accidental due to curious behaviors.

However, more than two-thirds of exposures among teenagers were intentional, according to the study. During the study period, the rate of opioid-related suicides doubled among this population.

Teenagers were also observed to have a greater likelihood of being admitted to a healthcare facility and experiencing serious health outcomes than young children, according to the study.

The authors said that parents need to increase awareness regarding these trends, and take steps to prevent teenagers from gaining access to opioids. Approximately 70% of teenagers use prescription drugs without a prescription, which highlights the need to safely secure opioids and other potentially harmful drugs, according to the study.

The authors call for opioids packaging to be altered so missing doses can be quickly identified. They suggest packaging the drug in blister or single-dose packs rather than loose pills, which may also prevent unintentional overdoses.

"The opioid crisis which has been affecting our adult population has now trickled down to our children," said study author Marcel Casavant, MD. "When adults bring these medications into their homes, they can become a danger to the children that live there. It is important that these medications are stored up, away and out of sight of kids of all ages, in a locked cabinet is best."