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The Circumstances Surrounding Fatal Pediatric Opioid Poisonings, 2004-2020
Julie R Gaither1,2, Sarah McCollum1, Kirsten Bechtel1
1Department of Pediatrics, Yale School of Medicine, New Haven, Connecticut.
Pediatrics
|November 1, 2024
Summary
Fatal pediatric opioid poisonings are often linked to caregiver substance use and child maltreatment, predominantly occurring in the home. Interventions and naloxone access are crucial for affected families.
Area of Science:
- Public Health
- Toxicology
- Pediatrics
Background:
- Understanding the factors contributing to fatal pediatric opioid poisonings is limited.
- Pediatric opioid fatalities encompass deaths from prescription opioids, heroin, and illicit fentanyl.
Purpose of the Study:
- To characterize opioid fatalities in children (0-17 years) by examining child, family, and household factors.
- To identify circumstances surrounding pediatric opioid poisoning deaths using national data.
Main Methods:
- Utilized data from the National Fatality Review-Case Reporting System (NFR-CRS) from 2004-2020.
- Analyzed 1696 cases of pediatric opioid poisoning deaths, stratifying by age groups (0-4, 5-9, 10-14, 15-17 years).
Main Results:
- Most poisonings (65.3%) occurred in the child's home; prescription opioids were involved in 91.8% of deaths.
- Co-poisonings with nonopioid substances occurred in 43.2% of cases.
- Significant percentages of decedents had a history of substance use (caregiver or child) and/or previous child maltreatment, particularly in younger and older age groups.
Conclusions:
- Child maltreatment and substance use (caregiver or child) are prevalent factors in fatal pediatric opioid poisonings.
- Interventions targeting opioid prescribing, storage, disposal, and misuse are recommended for all families.
- Universal access to naloxone is urgently needed for families with a history of maltreatment and/or substance use.
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