Studies shed light on opioid exposures among U.S. children and young adults

[March 21, 2017] By Andrew M. Seaman

(Reuters Health) - Between 2000 and 2015, poison control centers in the United States received 188,468 calls about prescription opioid exposures in children and teens, a new study finds.

That translates to roughly 11,700 calls per year placed to poison control centers, researchers say.

"We knew that we were in the middle of an opioid epidemic across the country - certainly in central Ohio, where we’re located," said study author Dr. Marcel Casavant, who is chief of toxicology at Nationwide Children's Hospital and medical director of the Central Ohio Poison Center in Columbus.

The study sheds light on how opioids - including painkillers like hydrocodone or oxycodone - impact young people, he told Reuters Health.

Casavant said data from the National Poison Data System shows that children age 5 and younger usually came in contact with opioids through "exploratory exposures" - such as when a child sees and eats a pill while crawling around on the floor.

Children ages 6 to 12 were usually the victims of medication errors, for example, when they were given the wrong dose or accidentally given a second dose.

Calls about teenagers and young adults were mostly due to intentional exposures, such as suicide attempts or drug abuse.

The researchers report in the journal Pediatrics online March 20 that opioid exposures among children and adolescents rose about 86 percent between 2000 and 2009 and then fell somewhat between 2009 and 2015.

The decline, Casavant said, might mean that doctors are being more careful in prescribing opioids, parents are getting better at keeping the medications out of reach or locked away, and there's improved technology for deterring people from obtaining large amounts of opioids.

The downturn may also mean people are switching to street drugs like heroin, as opioids become increasingly more difficult to get, he cautioned.

Despite the downward trend, the number of opioid exposures among teens was still higher in 2015 than in 2000, Casavant said. Also, his team's data doesn't account for all exposures to opioids, only the ones resulting in calls to poison control.

A companion paper in Pediatrics March 20 reports a strong link between prescribed opioids and their recreational use. Teens who abused opioids were often prescribed the drugs at some point by a doctor.

Sean Esteban McCabe of the University of Michigan in Ann Arbor and colleagues analyzed nationally representative studies of high school seniors collected between 1976 and 2015. About a quarter of the students reported using opioids for medical and non-medical uses. Here too, medical and non-medical use of the drugs declined between 2013 and 2015.

Drs. David Rosen and Pamela Murray of West Virginia University in Morgantown write in an editorial that other research supports a recent decline in the use of opioids, but they caution that the decline is not true for all of the U.S.

"The epidemic of opioid use disproportionately affects some urban and more rural areas," they write.

Casavant advises that poisonous materials be kept out of sight and out of reach. Regarding opioids, he says, "We need to lock these up."
 

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