The rate of pediatric mortality associated with prescription and illicit opioids rose 3-fold between 1999 and 2016, with 9000 deaths during this period, according to a study published in JAMA Network Open.

Researchers from the Yale School of Medicine retrospectively analyzed cross-sectional mortality data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database for children and adolescents age <20 years who died from prescription and illicit opioid poisonings between 1999 and 2016 (n=8986). They also examined deaths associated with ≥1 prescription or illicit substance in patients ages 16 to 19 years.

There was an increase in the overall pediatric mortality rate from 0.22 per 100,000 (95% CI, 0.19-0.25) in 1999 to 0.81 per 100,000 (95% CI, 0.76-0.88) in 2016, corresponding to an increase of 268.2% (P <.001). Significant increases during this time were observed in deaths of children ages 0 to 4 (225.0%; P <.001), 5 to 9 (100.0%; P <.001), and 10 to 14 (150.0%; P <.001).

The highest increase in rate of opioid-related mortality occurred in adolescents age 15 to 19 years, with an increase from 0.78 per 100,000 (95% CI, 0.68-0.88) in 1999 to 2.75 per 100,000 (95% CI, 2.55-2.96) in 2016, representing an increase of 252.6% (P <.001). In this age group, 31% of opioid-related deaths were attributed to synthetic opioids. In the older adolescent age group, 85.3% of opioid-related deaths were unintentional, compared with 38.0% in children <5 years.

Study limitations include the retrospective nature of the research.

“This public health problem is likely to grow unless parents, legislators, public health officials, and clinicians — including physicians who prescribe opioids to adults — begin to take a wider view of what is a systemic crisis,” noted the study authors. “Isolated solutions that fail to account for how entire families and communities are affected by adult opioid use are unlikely to lead to a substantive reduction in opioid deaths for either children or adults.”

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Reference

Gaither JR, Shabanova V, Leventhal JM. US national trends in pediatric deaths from prescription and illicit opioids, 1999-2016. JAMA Netw Open. 2018;1(8):e186558.