Pediatric and Adolescent Exposures to Buprenorphine That Warrant Poison Center Attention :

There is likely no one reading this blog who isn’t aware of the opioid crisis. Treatment strategies to curtail the use of opioids in teenagers and adults can often involve the substitution of a street opioid for a prescription opioid—i.e. buprenorphine—a mixed opioid agonist–antagonist used to help those addicted to opioids become less and less drug dependent. Yet put in the wrong hands of a young child who accidentally ingests buprenorphine or a teenager who uses it for intentional harm to themselves—a toxic exposure can occur, warranting a call to a poison center.  So just how common is a buprenorphine exposure that gets to the attention of a regional poison control center?  Post et al. (10.1542/peds.2017-3652) answer that question by looking at a decade’s worth of buprenorphine exposures reported to the National Poison Data System from 2007-1016 and found more than 11,000 reports of buprenorphine being accidentally or intentionally ingested.  More than 85% of those exposed to buprenorphine were less than 6 years of age, of which almost 90% were unintentional and involved the single substance itself.  In teenagers, however, almost 80% were intentional overdoses, a third involving other substances, and 12% of these were suicide gestures.  In both children and teenagers, hospitalizations resulted along with serious medical outcomes. To better understand just what those outcomes were, and what might be done to prevent these exposures from occurring, (e.g. unit-dose packaging), get a good dose of the information contained in this data-driven article—which is essentially a prescription for how we might prevent exposures or ingestions from occurring going forward.  Don’t withdraw from the opportunity to learn as much as you can about toxic buprenorphine drug exposures.  You and your patients who have access to this drug will be glad you did.