The rate of pediatric mortality associated with prescription and illicit opioids rose 3-fold between 1999 and 2016, with 9000 deaths during this period, according to a study published in JAMA Network Open.

Researchers from the Yale School of Medicine retrospectively analyzed cross-sectional mortality data from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research database for children and adolescents age <20 years who died from prescription and illicit opioid poisonings between 1999 and 2016 (n=8986). They also examined deaths associated with ≥1 prescription or illicit substance in patients ages 16 to 19 years.

There was an increase in the overall pediatric mortality rate from 0.22 per 100,000 (95% CI, 0.19-0.25) in 1999 to 0.81 per 100,000 (95% CI, 0.76-0.88) in 2016, corresponding to an increase of 268.2% (P <.001). Significant increases during this time were observed in deaths of children ages 0 to 4 (225.0%; P <.001), 5 to 9 (100.0%; P <.001), and 10 to 14 (150.0%; P <.001).

The highest increase in rate of opioid-related mortality occurred in adolescents age 15 to 19 years, with an increase from 0.78 per 100,000 (95% CI, 0.68-0.88) in 1999 to 2.75 per 100,000 (95% CI, 2.55-2.96) in 2016, representing an increase of 252.6% (P <.001). In this age group, 31% of opioid-related deaths were attributed to synthetic opioids. In the older adolescent age group, 85.3% of opioid-related deaths were unintentional, compared with 38.0% in children <5 years.

Study limitations include the retrospective nature of the research.

“This public health problem is likely to grow unless parents, legislators, public health officials, and clinicians — including physicians who prescribe opioids to adults — begin to take a wider view of what is a systemic crisis,” noted the study authors. “Isolated solutions that fail to account for how entire families and communities are affected by adult opioid use are unlikely to lead to a substantive reduction in opioid deaths for either children or adults.”

Related Articles

Reference

Gaither JR, Shabanova V, Leventhal JM. US national trends in pediatric deaths from prescription and illicit opioids, 1999-2016. JAMA Netw Open. 2018;1(8):e186558.

This article originally appeared on Clinical Pain Advisor