30 Oct Rapid Rise in Opioid Poisonings and Hospitalizations Among Children and Adolescents
MedicalResearch.com Interview with:
Julie R Gaither, PhD, MPH, RN
Postdoctoral Fellow in Biostatistics
Yale School of Medicine
MedicalResearch.com: What is the background for this study?
Response: In light of the prescription opioid epidemic that has affected the adult US population in recent years, our objective with this study was to examine how hospitalization rates for prescription opioid poisonings have changed over time in the pediatric population.
In addition, because prescription opioids are thought to be a precursor to illicit opioid use, we examined in older adolescents hospitalization rates for heroin overdose.
In all children, we determined whether the poisoning was of an accidental nature or could be attributed to suicidal intent.
To address these questions, we used the Kids’ Inpatient Database, a nationally representatives sample of pediatric hospital records released every three years, starting in 1997.
MedicalResearch.com: What are the main findings?
Response: There are four key findings from this study.
First: For 6 years of data, from 1997 to 2012, we identified approximately 13,000 hospitalizations for prescription opioid poisonings in children and adolescents 1 to 19 years of age. The annual hospital admissions for prescription opioid poisonings rose nearly two-fold during this time.
Second: Across all time points, the largest number of hospitalizations for prescription opioid poisonings occurred in adolescents, 15 to 19 years of age, Yet, we were surprised to find that the largest increase over time actually occurred among the youngest children—those 1 to 4 years of age, where the rates more than doubled over time.
Third: We found in older teens that hospitalizations for heroin overdose in 2012 were approximately 1.5 times the rate in 1997. Importantly, poisonings from methadone, a prescription opioid used to treat opioid addiction as well as chronic pain, increased by 950%, or nearly 10-fold in approximately a decade and a half.
4th: Regarding intent, in younger children, most poisonings were attributed to accidents; however, in teens most poisonings were suicidal in nature. In this age group, however, we found that accidental poisonings increased at a more rapid rate than those attributed to suicide. Accidental poisonings increased nearly 3-fold over time.
MedicalResearch.com: What should readers take away from your report?
Response: Hospitalizations increased across all age groups, yet young children and older adolescents were found to be most vulnerable to the risks of opioid exposure.
The vast majority of opioid poisonings in young children—toddlers and preschoolers—are the result of unsupervised ingestions of medications prescribed for an adult (parent, grandparent) in the household. The clear message here is that opioids should be treated in much the same way as anything else is that can cause harm to a child: Opioids should be kept locked-up and out of the reach of young kids.
In teens, our findings mirror what we’ve seen happening in the adult population, where opioid poisonings from both illicit and prescription opioids are on the rise.
MedicalResearch.com: What recommendations do you have for future research as a result of this study?
Response: Overall, our study illustrates that the current public health crisis caused by prescription opioids is one that affects everyone—from the very young to the elderly. Opioid poisonings in the young are likely to remain a growing problem unless further attention and resources are paid to the impact of the crisis on the pediatric community.
Reducing pediatric opioid poisonings will require a combination of strategies, including public health interventions (e.g., parental and provider education), policy initiatives that target children and adolescents, and consumer-product regulations that will result in safer packaging (e.g., combination locking caps vs. child-proof caps) and better labeling. Additionally, further research is needed to better understand opioid misuse and abuse in teens.
MedicalResearch.com: Is there anything else you would like to add?
Response: We found in teens 15 to 19 years of age a slight but statistically significant decrease in hospitalization rates from 2009 to 2012. Rates decreased by approximately 7% during this time. However, as I previously mentioned, heroin rates continued to climb during this time.
MedicalResearch.com: Thank you for your contribution to the MedicalResearch.com community.
National Trends in Hospitalizations for Opioid Poisonings Among Children and Adolescents, 1997 to 2012
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