Every 45 minutes, on average, a call is made to a poison control center in the United States about a child being exposed to prescription opioids.
That’s 32 calls every day from January 2000 through December 2015, according to a new study conducted by the Center for Injury Research and Policy, and the Central Ohio Poison Center at Nationwide Children's Hospital in Columbus, Ohio.
The research was published today in the journal Pediatrics.
Researchers said the data show the current opioid crisis is affecting not just adult Americans but their children, through both accidental and intentional misuse.
“We knew we would find something, but the numbers smacked me across the face,” Dr. Marcel Casavant, one of the study’s authors, told Healthline. “This is really a lot of kids.”
What the numbers show
More than 188,000 calls came into U.S. poison control centers regarding pediatric exposure to opioids during the time period studied.
About 60 percent of those were regarding children younger than age 5.
The second most common age group affected was teenagers. More than two-thirds of those incidents were intentional. That represented a 50 percent increase in suspected teenage opioid-related suicides over the 16 years covered by the study.
Since 2009, exposures have actually decreased, but researchers said that news comes with two caveats.
Incidents involving buprenorphine, a prescription drug used to help people addicted to opioids, have continued to climb. The study notes nearly half of those incidents have been serious enough to warrant admitting the patient to a healthcare facility.
And it’s possible the overall decrease could be partly due to people turning to nonprescription opioids, exposure to which wasn’t included in this study.
“So maybe it means good news, maybe it means legal and pharmaceutical and education actions are finally paying off and we’re getting control of this epidemic. But maybe it means people have just been driven to street drugs, like heroin,” said Casavant, who is medical director of the Central Ohio Poison Center and chief toxicologist at Nationwide Children's Hospital.
The heroin problem
Deaths from heroin overdoses have increased sharply since 2010.
However, that increase doesn’t necessarily mean children have an increased risk of exposure to drugs like heroin in the home.
Unlike a bottle of pills that might be lying on the bathroom counter, “people tend to be a lot more careful with heroin,” Casavant notes.
Dr. Nicole Villapiano, a University of Michigan pediatrician who was not involved with the study, told Healthline the findings are consistent with what she sees in her own practice.
“When you're working in the ER, it feels like a nearly daily occurrence” to see children or teenagers exposed to opioids, said Villapiano, who has conducted research on increasing numbers of babies born with drug withdrawal symptoms from opioids.
She called the new findings “yet another unintended consequence of prescription opioids.”
How to reduce the problem
Not all of the child exposure to opioids can be avoided, but using different packaging or administering the drugs differently could lower the numbers.
In the case of exposure to buprenorphine, Villapiano thinks those incidents could be cut by administering the drug via an implantable rod — rather than the more common pills or dissolvable strip — more frequently, removing the possibility of misuse by another individual.
More broadly, adult Americans are allowed by law to request prescriptions in nonchild-resistant containers, letting the elderly or those with disabilities avoid hard-to-open bottles.
Casavant said that’s fine if you’re careful with those bottles, but if there are children in the house or you, say, carry them in your purse to a house with kids, it’s risky.
“The story we hear all the time is, ‘I just turned around for a second, I turned back, and my kid ate 10 or 15 pills,’” he says.
Child-resistant containers are no guarantee, though, particularly in terms of a teenager who intends to deliberately ingest the pills.
But both accidental and intentional exposures might be reduced through the use of different packaging, such as blister packs that require each pill to be punched out individually.
Casavant says that around half the teenagers he sees in the ER and his clinic who have attempted suicide regret it immediately after the attempt, leading them to call the poison control hotline or run to tell their parents.
Punching out individual pills won’t prevent suicide by overdose, but it could give teenagers more time to change their minds before it’s too late.
He noted that situations like that are where calls to a poison control center are critical. The study found most of the cases called into the centers were able to be handled at home with the guidance of the call center staff.
The Poison Control hotline in the United States is 1-800-222-1222. There are poison control specialists available 24 hours a day, 7 days a week.