While the scope the opioid crisis has become apparent to most people in this country, most of our broad understanding of the challenges we face are a result of its impact on adults. Relatively little is known about how children are affected and what we have known is often based either on extrapolation from data related to adults or indirect measurement. Childhood opioid poisonings are one such example.
Up until this point we knew how many children each year presented to hospital emergency departments with opioid poisoning and how many of those children died. However, for the first time researchers carefully examined trends in pediatric deaths from opioid poisonings and published their findings in JAMA Open Network last month. What they revealed is startling and should serve as a call to action.
- Between 1999 and 2016 just under 9000 children died from opioid poisonings and 38% of those deaths occurred at home.
- During that time period the mortality rate for children from opioid poisonings increased by 300%, poisonings by prescription opioids increased by 95% and heroin overdoses in adolescents increased by 400%.
- 73% of those who died were males.
- 73% of those poisonings were from prescription opioids.
- 7% of the deaths were children under the age of 5.
- 25% of the deaths in children under the age of 5 were actually homicides.
- Adolescents make up 80% of the deaths and heroin was the primary cause of death in 1900 of the deaths in children between the ages of 15 and 19.
We all must work to identify effective prevention strategies, including education, safer packaging and storage of prescription opioids and of the medications we use to treat opioid use disorder (methadone and buprenorphine), and promotion of responsible prescribing practices. Naloxone, the antidote for opioid overdose, should be in every home in which there is a prescription for opioid medications, and should be easily accessed by people who use drugs and by those who care for them. We must develop reliable screening for substance use among pre-adolescents and adolescents so that early interventions can be offered. We must strengthen community and public health support for struggling families. And we must be be certain that appropriate treatment is available if they have developed a substance use disorder.
What could be more important?