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Yaron Finkelstein1,2,3, Szimonetta Komjáthiné Szépligeti4, Erzsébet Horváth-Puhó4

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Children with family members prescribed opioids face a significantly higher risk of serious opioid intoxication events (SOEs), including death. This highlights the need for public health strategies to address pediatric risks in the opioid crisis.

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Area of Science:

  • Public Health
  • Epidemiology
  • Pediatrics

Background:

  • Opioid overdose deaths are a global crisis, with 480,000 annual fatalities.
  • The risk of pediatric serious opioid intoxication events (SOEs) linked to family prescriptions remains largely unknown.

Purpose of the Study:

  • To quantify the association between opioid prescriptions for household family members and SOEs in children.
  • To compare risks between children exposed to family opioid prescriptions, nonsteroidal anti-inflammatory drugs (NSAIDs), or no analgesic prescriptions.

Main Methods:

  • A population-based, case-control study utilizing Danish national registries from 1995-2022.
  • Included over 3.7 million residents under 20 years; identified SOEs (death, hospitalization, ED visit) and matched them with controls.
  • Analyzed opioid prescriptions filled by family members within 3 months prior to a child's SOE, controlling for confounders.

Main Results:

  • Children with a family member who filled an opioid prescription had 2.87 times higher odds of an SOE compared to unexposed children.
  • The odds of SOE were 2.22 times higher compared to children with family members prescribed NSAIDs.
  • Children exposed to family opioid prescriptions had nearly 4-fold higher odds of opioid-related death.

Conclusions:

  • Family opioid prescriptions are associated with significantly increased odds of pediatric SOEs and opioid-related deaths.
  • Public health initiatives addressing the opioid crisis must incorporate pediatric-specific risks.
  • Further research and targeted interventions are needed to protect children from household opioid exposure.