At Least 9,000 Teens and Children  Have Died from Opioid Overdoses

At Least 9,000 Teens and Children Have Died from Opioid Overdoses

A study in the Journal of the American Medical Association (JAMA) has found that at least 9,000 teens, pre-teens and toddlers have died from opioid overdoses in the past 20 years, tripling the pediatric opioid mortality rate.

Titled US National Trends in Pediatric Deaths From Prescription and Illicit Opioids, 1999-2016, the study is from the Department of Pediatrics at Yale School of Medicine, New Haven, Connecticut.

The cross-sectional study analyzed mortality data from the Centers for Disease Control and Prevention for 8,986 children and adolescents under the age of 20, who died between 1999 and 2016 from prescription and illicit opioid poisonings.

In that 17-year period, the pediatric mortality rate increased 268.2% - nearly triple what it was.

(A cross-sectional study analyzes data from a population or a representative subset of the population - a "cross-section" - at a specific point in time.)

The overall pediatric mortality rate from prescription opioid painkillers and illicit opioids like heroin and the big killer, fentanyl, rose 268.2%. This is a dramatic rise from 0.22 per 100,000 in 1999 to 0.81 per 100,000 in 2016.

Every age, from newborn to 19, suffered a huge increase in deaths.

Teenagers aged 15-19 were hit the hardest, with a soaring mortality rate of 252.6%. But even the youngest children, aged 0-4, suffered a 225.0% increase.

Kids and opioid prescriptions

The rise in pediatric opioid poisonings roughly parallels that of the adult population. In other words, the much-discussed opioid epidemic very much includes the entire age spectrum of Americans, from the cradle to the grave.

Teens experiment with opioids and other drugs, and often pilfer opioids from older relatives. Being largely ignorant of the real dangers, they leave themselves open to sudden accidental overdoses.

Smaller children and toddlers, however, fall victim to accidental ingestion of pills left in view and easily accessible. They see mommy swallowing the little colored candies, and when she's not looking or leaves the room, the tragedy happens.

Lead author of the study, Yale's Julie Gaither, PhD, told MedPage Today that regulations covering education and safety need to be improved and added to all routine opioid prescriptions.

"The primary thing we need to consider - public health officials, legislators, clinicians, and parents - is how everyone is affected in the home when an adult brings an opioid into the house," Gaither said. This should include "administering safety recommendations and disposal instructions based on who is in the home along with opioid prescriptions," she added.

Kids and synthetics such as fentanyl

We've all been reading and hearing about fentanyl, the super-powerful synthetic opioid that's reared it's deadly head over the past few years in all its constantly changing illicit analogs.

Pharmaceutical prescription fentanyl also makes an appearance now and then in the wild, itself a powerful and deadly opioid gone astray from a hospital, clinic or drug store.

But the illicit fentanyl and its analogs from clandestine labs here and in China, appear on the street faster than the DEA can find, confiscate, analyze and add it to the list of illegal substances. Until that can happen, new killer fentanyl analogs are technically legal.

Because of the time involved, a federal science agency has launched a new high-tech program hooking up labs around the world to help find and test drugs faster than ever before.

But legality isn't the core problem. The availability of fentanyl in any form is the real problem.

Yes, it's acknowledged that prescription opioids are driving the opioid epidemic. But illicitly manufactured fentanyl, legal or not, is what killed at least a third of all the teens experimenting with opioids in the most recent years of the Yale study.

"With our data, we were not able to distinguish between what was pharmaceutical fentanyl and what was illicitly manufactured fentanyl, and no study is able to do that," Gaither told MedPage Today. "But these are likely illicitly manufactured drugs [and] that's very troubling that teens are getting hold of these illegal drugs that are 50 to 100 times more potent than heroin."

Simply knowing all this data isn't a quick fix, because there is no quick fix. Getting serious about packaging better instructions with opioid prescriptions, getting serious about ramping up schoolroom education about opioids (and all drugs for that matter) and getting serious about more funding for better treatment - these are the areas that can lead to the solution we're all working towards.

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