The exposure of children to buprenorphine increased by 215% in three years

(CNN) – More than 11,200 calls regarding children's exposure to buprenorphine, an opioid medication used to treat opioid-related disorders, were conducted in US poison centers between 2007 and 2016, according to a new study. Eighty-six per cent of exposures involved children under six years of age; 89% of exposures were involuntary.

"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're not quite sure why this stands out, maybe parents who have this do not think it's as risky as their other opiates because they're not." They do not have the same effect as other opiates. , referring to the fact that the drug is omitted or within the reach of children who try it next.

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.

"This is not the first study to show these data, but it's the latest study to show a drug whose goal is to help addicted adults or narcotics to end up poisoning, especially unintentionally." , children and especially the most vulnerable, "said Kane, who was not involved in the new research, but conducted a recent study that found that the number of opioid overdoses in children had almost doubled since 2004.

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 misuse of buprenorphine was seen in adolescents, adolescent girls accounted for nearly 60% of suspected suicides in this group, the authors note.

"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.

The approval of a subcutaneous buprenorphine implant in 2016 could also reduce children's access, noted the study, because patients with an implant would not have any pills for children.

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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