Severity of opioid overdoses increases among kids

More than one in four opioid poisonings involve children and adolescents, and the severity of hospital admissions for acute opioid ingestions has increased over a recent 14-year period, according to findings presented at the Society of Critical Care Medicine’s Critical Care Congress.

The study is a more comprehensive examination of the impact of opioid poisonings on children and adolescents, according to a press release. The scope of previous research has been limited to deaths caused by opioid exposures.

Researchers assessed 753,592 opioid poisoning cases reported to the National Poison Data System between 2005 and 2018. Of these, 207,543 (27.54%) involved children aged younger than 19 years. Specifically, they found that:

• The proportion of those who died from opioid exposure increased from 0.18% to 0.28%.
• The percentage of those who had suicidal intent with opioids increased from 13.9% to 21.2%.
• The percentage of those who were administered naloxone increased from 42.3% to 50.8%.
• The percentage of critical care unit admissions increased from 6.6% to 9.6%.
• The likelihood of the overdose being life-threatening and causing significant disfigurement (such as intubation and mechanical ventilation, ventricular fibrillation and rhabdomyolysis with myoglobinuria, marked creatine-phosphokinase elevations or increased creatinine, according to researchers) or disability increased from 0.10% to 0.13%.

According to the researchers, fentanyl (OR = 12; 95% CI, 9.2-15.7), heroin (OR = 11.1; 95% CI, 9.4-13.1) and methadone (OR = 15; 95% CI, 13-17.3) were the opioids most strongly associated with having a pediatric ICU procedure.

 

More than one in four opioid poisonings involve children and adolescents, and the severity of hospital admissions for acute opioid ingestions has increased over a recent 14-year period, according to findings presented at the Society of Critical Care Medicine’s Critical Care Congress.

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“There are no time periods being compared,” Megan Land, MD, of the pediatric critical care unit at Emory School of Medicine and study co-author, told Healio Primary Care. ”Instead, we used a logistic regression analysis here to calculate an adjusted odds ratio of having any pediatric ICU procedure as a function of opioid type. In our data, illicit opioids, such as heroin, and synthetic opioids, including methadone, were associated with increased odds of requiring a critical care unit procedure performed."

The findings are a call to action, according to study co-author Jocelyn Grunwell MD, PhD, an assistant professor of pediatric critical care at Emory University.

“Parents, pediatricians, teachers, coaches, counselors, everyone who interacts with children and adolescents needs to be aware of the risk of self-harm, misuse and abuse of opioids, and restrict access to them in the home. And clearly there’s a need for effective policy changes to better identify children with mental health issues and help them and their families get services to prevent suicide attempts,” Grunwell said.

Study results recently published in The Journal of Pediatrics suggest that in more than half of cases in which young children get access to prescription pills, the child-resistant packaging had already been removed by an adult. – by Janel Miller

References:

Agarwal M, et al. J Pediatr. 2020;doi:10.1016/j.jpeds.2019.12.027.

Land M, et al. Analysis of 207,543 children with acute opioid ingestions from the National Poison Data System. Presented at: Society of Critical Care Medicine’s Critical Care Congress; Feb. 16-19, 2020; Orlando.

Disclosures: Healio Primary Care was unable to confirm relevant financial disclosures at the time of publication.