March is National Poison Prevention Month to raise awareness about what we can do to help families keep their children safe from preventable ingestions and toxic exposures. To help celebrate this important preventive health month, we are early releasing two studies that will officially appear in our March issue focused on two aspects of adults having opioid pain relievers in the home with young children. The first deals with issues of safe storage and the second with overdose risk in children who gain access to these medications.
The first study on safe storage of opioids by McDonald et al. (10.1542/peds.2016-2161) focuses on survey results of a national sample of adults who self-reported the need for opioid pain relievers (OPRs) and had children less than 18 years living at home with them. Questions were asked regarding safe storage of these medications (meaning having them latched or lacked away). Sadly, just under a third of the 681 adults who were surveyed and had young children in their home practiced safe storage and just over 10% used safe storage with older children at home. So are there factors to differentiate those families who practiced safe versus unsafe storage? There are, and they involve a number of issues ranging from efficacy of the medication to relieve their pain to awareness of concerns were their children to access those medications. Better education of adults who take prescription opioids is needed—so feel free to share this study with colleagues who care for the parents of your patients since they may want to remind families along with you of the importance of keeping all prescription medications secure from young ones in the home.
The second study by Finkelstein et al. (10.1542/peds.2016-2887) looks at 20 years of opioid overdoses in children in homes where prescription opioids were present. The authors share the results of a population-based nested case-control study performed in Ontario involving children 10 years of age or less living in a home where either an opioid or non-steroidal anti-inflammatory medication (serving as control cases) had been prescribed and whether children were hospitalized or died from an opioid overdose. Over twenty years, just over 100 children in Ontario died of an opioid overdose with half being less than 2 years of age. The odds of these children having a mother prescribed an opioid or an antidepressant was far greater than those who had not had them prescribed. This study combined with the first provides a sobering dose of concern and should lead to all of us working with adult clinicians and pharmacists to come together and work to limit the amount of drug administered by prescription, , make sure the drug is well–stored at home away from children, and when done using it, we should also review how to properly dispose of these medications in an environmental and safe way so that children cannot discover these drugs in the trash where they can have easy access to them thinking they might look like candy. If you need more info on how to properly dispose of expired or used medications whether they are opioid or not, check with your local pharmacist so you can provide the expertise needed (if you don’t have it already) to prevent the overdoses from unsafe storage and discarding of opioid and other medications in the home of your patients.