Buprenorphine exposures increase in American children and adolescents

According to researchers, poison control centers in the United States received 11,275 exposure returns between 2007 and 2016. Most of these exposures occurred in children under 6 years of age and were accidental; However, more than three quarters of teen shows were intentional.

Researchers reported that 12% of these intentional teen exposures involved suicide attempts.

"From 2005 to 2010, the annual number of patients who received a buprenorphine prescription increased from 100,000 to more than 800,000" Gary A. Smith, MD, DrPH, Director of the Injury Research Center and Policy at Nationwide Children's Hospital, said Infectious diseases in children. "From 2007 to 2010, buprenorphine exposure rates in children increased by more than 200%, which is likely attributable to the increase in the number of buprenorphine prescriptions dispensed."

The researchers noted that in 2016, the AAP suggested the use of buprenorphine in adolescents with severe opioid use disorders. Due to the likelihood of an increase in pediatric and adolescent exposures, Smith and his colleagues evaluated the number of incidents in which US poison control centers were contacted for children aged 19 or younger in 2007 to 2016.

Researchers observed an exposure rate of 6.4 per 1,000,000 in 2007. This rate increased by 215.6% in 2010 (20.2 per 1,000,000). A decrease of 42.6% was observed between 2010 and 2013 (11.6 per 1,000,000), but this rate increased again by 8.6% in 2016 (12.6 per 1,000,000).

Smith and colleagues reported that most exposures occurred in children under 6 years of age (86.1%). These exposures were generally involuntary (89.2%) and substance-related (97.3%). However, children in this age group who were exposed to a substance were about twice as likely to be admitted to the hospital or to have serious adverse outcomes compared to teens.

Although teenagers accounted for only 11.1% of exposures reported to poison control centers, 77.1% of these exposures were intentional. More than a quarter of these exposures included several substances (27.7%). When adolescents were exposed to several substances, the probability of hospitalization was almost five times higher and serious adverse events were nearly three times more likely than exposure to buprenorphine alone.

"Safe storage of all opioids, including buprenorphine, is crucial.Parents and caregivers who use buprenorphine must store it safely: standing, away and out of sight." A locked cabinet is the better, "said Smith. "Health care providers should inform caregivers of young children about the dangers of exposure and provide instructions on proper storage and disposal of medications. In addition, adolescents should be given information about the risks of substance abuse and abuse. The percentage of exposures attributable to suspected suicide in this age group underscores the need for access to mental health services. "- by Katherine Bortz

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