The rates of fatal opioid poisonings among children and teens rose 268% from 1999-2016, according to new research being presented during the Pediatric Academic Societies (PAS) meeting in Baltimore.
Researchers analyzed data from the Centers for Disease Control and Prevention on children ages 19 and under who died of opioid poisoning. There were nearly 9,000 such deaths from 1999-2016. During that time, the rate rose from 0.22 per 100,000 children to 0.81 per 100,000, according to the abstract “Geographic Variation in Pediatric Deaths from Prescription and Illicit Opioid Poisonings, 1999-2016.”
The Northeast region had the highest rates at the beginning and end of the study period, while the Midwest experienced the biggest increase (429%). The West had the smallest rate increase at 200%.
The North, South and East regions all experienced large increases among 15- to 19-year-olds from 2013-’16 driven by heroin and synthetic opioids like illicit fentanyl.
“We are interested in finding out what is at the root of this variation, and whether there are public health policies in place in the West that are serving as safeguards for kids; and if so, how do we begin to implement them across the rest of the country,” lead author Julie Gaither, Ph.D., M.P.H., R.N., said in a news release.
Another team of researchers looked at opioid prescribing for children, teens and young adults enrolled in Medicaid.
They used data from the IBM Watson Medicaid Marketscan claims database from 2012-’16, which included more than 113 million clinical visits for people ages 1-21 years, of which 0.9% resulted in an opioid prescription.
About 36% of those filling an opioid prescription underwent dental surgery, 26% had outpatient surgery and 4% were emergency department visits, according to the abstract “Changes in Opioid Prescriptions for Medicaid-enrolled Children, 2012-2016.” With the exception of dental surgery, odds of a clinical visit resulting in an opioid prescription declined in each setting over the study period.
Just over half of the prescriptions were for hydrocodone, about a quarter were for codeine and 15% were oxycodone. Most were combined with acetaminophen or ibuprofen.
“Future efforts should support development of pediatric pain management guidelines based in a multimodal approach to minimize use of opioids and target reduction of opioids with pediatric safety warnings,” author Abbey Masonbrink, M.D., M.P.H., FAAP, said in a news release.
For additional AAP News coverage of the PAS meeting, visit http://www.aappublications.org/collection/pas-meeting-updates.
