Opioid prevention efforts among youth need improvement

Teenagers have a high probability of health care facility admission and serious medical outcomes relating to prescription opioids, with frequent exposure to the opioid buprenorphine among younger children, warranting better efforts to prevent opioid exposure among youth, according to data published in Pediatrics.

“Among teenagers aged 15 to 19 years, there was a 91% increase in fatal poisoning from 2000 to 2009, which was mostly attributable to an increase in prescription drug overdoses,” Gary A. Smith, MD, DrPH, director of the Center for Injury Research and Policy at Nationwide Children's Hospital and professor of pediatrics at The Ohio State University College of Public Health, and colleagues wrote. “Little research has been published examining opioid poisoning among children, particularly those [younger than] 6 years.”

To determine the epidemiology of opioid exposures among children younger than 20 years in the U.S., researchers analyzed data from the National Poison Data System between 2000 and 2015. The search identified 188,468 cases that met the study criteria of prescription opioid exposures among children younger than 20 years during the study period.

Early in the study period, the investigators observed that the annual number and rate of exposures increased, then later declined after 2009, although this excluded buprenorphine exposures, which increased during the last 3 study years. The results showed that hydrocodone accounted for 28.7% of exposures, the largest proportion among participants. Among children exposed to buprenorphine, 47.1% were admitted to a health care facility. Children aged 0 to 5 years accounted for the largest number of exposures, with nearly 90% of buprenorphine exposure among this age group, and 85.5% attributed to unintentional/nontherapeutic exposures.

The researchers found that adolescents were more likely to be admitted to a health care facility compared with children aged 0 to 5 years (2.86; 95% CI, 2.78-2.94) or those aged 6 to 12 years (4.59; 95% CI, 6.06-7.02). They also saw that teenagers had a greater chance of experiencing serious medical outcomes than children aged 0 to 5 years (3.03; 95% CI, 2.92-3.15) or those aged 6 to 12 years (4.59; 95% CI, 4.21-5). During the study period, the rate of prescription opioid-related suspected suicides among adolescents increased by 52.7%.

“Greater efforts are needed to prevent opioid exposure to children of all ages,” Smith and colleagues wrote. “Physicians can help reduce the availability of opioids by using correct dosing (not prescribing a higher dose or greater supply than necessary), reminding parents to safeguard prescription medications (including from teenagers), and encouraging prompt and proper disposal of unused medications.” – by Savannah Demko

Disclosure: Smith reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.