Prescription opioids in home put children at risk

Thousands of very young children is exposed to powerful painkillers, such as OxyContin (oxycodone) and Vicodin (acetaminophen and hydrocodone), they find in their homes every year, new research shows.

“Our results indicate that young children are endangered by prescription opioids,” J. Elise Bailey of the Rocky Mountain Poison and Drug Center—Denver Health and her colleagues warn in their report, published in the Annals of Emergency Medicine.

Abuse of prescription opioids is on the rise, and the number of deaths due to poisonings with these medications nearly doubled between 1999 and 2002, the researchers note. Given that most people who abuse prescription drugs are young adults, and that most new parents are young adults, they add, “concern is raised that their children may be exposed to these drugs.”

To investigate, Bailey and her team looked at information from poison control centers that participate in the Researched Abuse, Diversion and Addiction-Related Surveillance (RADARS) System for January 2003 to June 2006 on exposures to buprenorphine, fentanyl, hydrocodone, hydromorphone, methadone, morphine and oxycodone.

Among the 9,179 children for whom opioid exposures had been reported to RADARS, 8 died, while 43 suffered serious effects. The children ranged in age from newborn to 5.5 years old, while most were 2 years old. Ninety-nine percent of the children ingested the drug; 92 percent of cases occurred in the child’s home; and 6 percent took place in another person’s home, suggesting that opioids were discovered during toddlers’ exploration of their environment,” the researchers note.

They observed that high numbers of opioid prescriptions within a particular zip code area correlated with high numbers of accidental exposures to these drugs among children.

Because this report only included cases reported to poison control centers and only centers participating in a special surveillance system, it is likely an underestimate, the researchers say.

“Child-proof” packaging of these medications is likely not adequate protection, when just a single pill could kill, the researchers note. In most cases, they add, the child had found a lost pill or an open container.

“One tablet of an opioid analgesic may be lethal to a young child,” they point out, making interventions necessary to prevent accident exposures and to reduce deaths, they conclude.

SOURCE: Annals of Emergency Medicine, online September 2, 2008.