The underrecognized toll of prescription opioid abuse on young children.
OBJECTIVE
The impact of prescription opioid abuse on young children is underrecognized and poorly documented. We hypothesize that poisoning of young children from prescription opioids occurs regularly in the United States and is associated with serious health events, including death.


METHODS
Using data from poison centers participating in the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS) System, exposures in children younger than 6 years, involving buprenorphine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, and oxycodone (January 2003 to June 2006), were quantified and described.


RESULTS
We identified 9,179 children exposed to a prescription opioid. The median age was 2.0 years (range newborn to 5.5 years), and 54% were boys. Nearly all exposures involved ingestion (99%) and occurred in the home (92%). Exposures to any opioid were associated with 8 deaths, 43 major effects, and 214 moderate effects. Of 51 patients who experienced a major effect or death, 35 were treated with naloxone: a beneficial response was documented in 34 patients. All 5 exposures to buprenorphine associated with a major effect were treated with naloxone, and a beneficial response was recorded in all 5. Nearly all exposures were to medications prescribed for adults in the household. The number of prescriptions filled for an opioid in an area correlated well with exposures in young children in the same area; children have access to household members' prescription drugs.


CONCLUSIONS
Young children are exposed to prescription opioids, typically prescribed for other patients, resulting in major health effects and death.
Bailey
J Elise
JE
Rocky Mountain Poison and Drug Center-Denver Health, Denver, CO 80204, USA. J.Elise.Bailey@RMPDC.org
Campagna
Elizabeth
E
Dart
Richard C
RC
D016907:Adverse Drug Reaction Reporting Systems; D000701:Analgesics, Opioid / Q000506:poisoning*; D002047:Buprenorphine / Q000506:poisoning; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006853:Hydrocodone / Q000506:poisoning; D004091:Hydromorphone / Q000506:poisoning; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008691:Methadone / Q000506:poisoning; D009020:Morphine / Q000506:poisoning; D010098:Oxycodone / Q000506:poisoning; D011041:Poisoning / Q000453:epidemiology* / Q000401:mortality; D055553:Prescription Drugs / Q000506:poisoning*; D014481:United States / Q000453:epidemiology
D000701:Analgesics, Opioid; D055553:Prescription Drugs; D002047:Buprenorphine; D006853:Hydrocodone; D009020:Morphine; D010098:Oxycodone; D004091:Hydromorphone; D008691:Methadone