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"This is never prescribed for children under the age of 6. This is a significant risk for them," said Henry Spiller, director of the Central Ohio Anti Poison Center and author of the Study, published Monday in the journal Academics. "We are not quite sure why it stands out so much. Maybe parents who have this may not think it's as risky as their other opiates because it's not the great effect that other opiates do for them,"he said, referring to the fact that the drug is left or within reach of children who then try it.
According to Dr. Jason Kane, associate professor of pediatrics and intensive care at the Chicago University of Chicago Medical Hospital, experts consider these numbers as an unintended consequence of the medical treatment offered to those who need.
Of the 11,275 children exposed, the overall exposure rate for 1 million increased by 215.6% from 2007 to 2010 (from 6.4 to 20.2), then from 42.6% from 2010 to 11 , 6 in 2013, before increasing 8.6% to 12.6 in 2016.
Buprenorphine is both an opioid receptor stimulant and a blocker, explained Spiller, also a diplomat with the American Board of Toxicology. As a result, he does not provide the same "high" as other opiates, but he is still an opiate.
"In adults, the respiratory depression, the part that slows down breathing and you stop breathing, is limited, so there's a lot less respiratory depression in adults," Spiller said. "Unfortunately, in very young children under 5, preschoolers, toddlers, infants … this protection does not exist, and they suffer from respiratory depression."
Teenagers may not have the same risk as 5-year-olds, but they are not immune, he added. "The actual significant effects are additive, they worsen when you add things like alcohol, maybe another drug, other things."
In fact, although adolescents accounted for only 11% of total exposures, 77% of these exposures were intentional (with 12% suspected suicides), and more than 25% used buprenorphine with at least one other substance, according to the report. # 39; study.
"It was surprising that teenagers were using it for abuse, it's very specific," Spiller said. "You have to be in a program to get it, it's managed carefully, it's not widely available … It's available on the street, but basically the majority comes from these management programs and someone is in therapy, someone in the house, them or a family member. "
Although more than 60% of the abuse and / or abuse of buprenorphine was observed among adolescents, adolescent girls accounted for nearly 60% of the suspected suicides in this group, note the authors.
"In adolescents, there is a risk where we start to see an increased risk of suicide attempts, just like a part of adolescence," Spiller said. "But if it 's at home, it' s a really powerful drug, they can try to add that or use that as any drug that they use for drugs. suicide attempts. "
The authors of the study expect that nearly 2.1 million people in the United States with opioid use disorder and 11.5 million opioid prescription drugs , the number of children and adolescents exposed to buprenorphine will continue to increase.
"You would hide under a rock if you did not realize that there is a big opioid crisis, and that's one of the treatments for this addiction," Spiller said. "A number of these programs are trying to expand to accommodate a large number of these opioid-dependent patients, so I would expect to see more of that."
Nearly one-quarter of exposed children under the age of six spend time in intensive care, noted Kane.
"This burden we put into the health system is entirely preventable," he said. "These are children who do not need a hospital otherwise because they were accidentally poisoned by drugs that were not designed to be taken by them."
The authors of the study recommend an exposure prevention aligned with the age group of children. For example, making a single-dose package instead of an entire bottle of pills would help prevent unwanted exposure in young children, while locking drugs on a shelf can help prevent teens from going out.
Other suggestions include the disposal of unused medications, the placement of child-proof capsules on the containers and the fact of letting the drugs into boxes or vials properly labeled, a Kane said.
"Seven children under 6 years old died as a result of accidental poisoning of this drug, which was present in someone's home, prescribed with the aim of improving somebody's health. 39; other, "added Kane, adding that" it's a striking thing for me. "
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