The forgotten children of the American opioid crisis

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A new study published Wednesday in the journal Pediatrics shows the critically increasing number of children aged five and younger in the US who have died from opioid overdoses. 

The study found that 731 children aged five and under were among the fatalities between the years 2005 and 2018. While some were poisoned by over-the-counter pain or allergy medicines, most of the fatalities were from opioids.

In 2005, opioids accounted for 24.1% of the substances that caused child deaths, as opposed to the greatly higher number of 52.2% in 2018.

Co-author and associate fellow at the Children’s Hospital of Philadelphia, Dr. Christopher Gaw, stated, “It truly is striking to see, looking at this data, how different the proportions were between 2005 and 2018.”

Medicines became a bit harder for children to access after the Poison Prevention Packaging Act in 1970 was passed when harder-to-open childproof packaging became a standard requirement for many medicines.

Child abuse is a main factor

Prescription opioids were the drug of choice in the late 1990s and early 2000s, and when policies became stricter and the opioid epidemic hit, heroin and fentanyl became the go-to drugs.

Fentanyl, 100 times stronger than morphine, doesn't come in childproof packaging, making it easier for children to access. According to the Centers for Disease Control and Prevention (CDC), drug overdose deaths have increased five-fold since 1999, and a whopping 75% of the 91,799 recorded overdose deaths in 2020 were because of an opioid. 

Unfortunately, the study cannot show how opioids are within the reach of young children but it provides insights into the circumstances regarding how the deaths happened. 

Child protective services documents showed a history of child abuse in 153 cases, and over two-fifths of the children who died were less than a year old. More than 65% of the deaths happened at home. Nearly a third were under the supervision of someone who was not their biological parent.

40% of the deaths involved in the cases were due to accidental overdoses and a little less than 18% were deliberate.

Forgotten children 

With the study published, Dr. Gaw hopes that his research can educate and inform parents of the risks while expressing that he wishes to see a rise in the availability of naloxone, the opioid antidote, otherwise known as Narcan. 

Naloxone nose spray was subject to a unanimous vote in February by two independent advisory committees for the US Food and Drug Administration (FDA) to make it available over the counter. A decision has not been made yet.

According to Dr. Gaw, it is necessary for health systems to promote ways in which opioid access can be limited and if adults receive help, then children receive less danger and risk.

“It is incredibly sad, but I think it’s important to really highlight because we don’t want children to be forgotten in this epidemic, because they’re also at risk,” Gaw said, concluding: “Their risk is related to the larger world that they’re in.”