The national opioid problem is something we read about daily and perhaps encounter in the adolescents we care for or see in the family members of our patients (or even possibly in our own families). Yet most of the information about this epidemic is focused on adult usage, and one wonders how the increasing dependency on opioids in that population diffuses over to a pediatric population. Kane et al. (10.1542/peds.2017-3335) provide us with some answers in regard to changes in opioid admissions to the pediatric intensive care units (PICUs) in 31 free-standing children’s hospitals from 2004 to 2015 using the Pediatric Health Information System, a national database registry for hospitalizations that used billing data involving patients who received naloxone, vasopressors, and ventilation in association with a diagnosis of an opioid ingestion. Sadly almost half the 3647 hospitalizations discussed in this study required PICU care. Moreover during the time period studied, there was an increase in the rate of PICU hospitalizations. Even worse was that a third of the hospitalizations involved children under 6 years of age, admissions that likely should not have occurred if the opioid had not been available to this population of young children. For example, methadone was the culprit found almost 20% of the time in children under 6 years of age suggesting an adult had the drug at home that somehow got into the hands of a child.
So what do these troublesome findings mean? What is the cost, not just to the healthcare system but emotionally—both for families of hospitalized children and teens as well as for family members and society in general? Adolescent specialist Dr. Sheryl Ryan from Penn State-Hershey Medical Center has written an accompanying commentary (10.1542/peds.2017-4129) to share with us her thoughts on the toll taken by the opioid crisis and challenges us to do even more from a prevention standpoint. By doing what Dr. Ryan suggests, we can hopefully prevent the use or ingestion of opioid products. This study and commentary are hard pills to swallow, and will hopefully be habit-forming in terms of our doing even more to prevent opioid ingestions and usage in our patients, across all age groups. Read both and you’ll see what we mean.
