Opioids Now Account for More Than Half of Child Poisoning Deaths : AJN The American Journal of Nursing

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Opioids Now Account for More Than Half of Child Poisoning Deaths

AJN, American Journal of Nursing 123(6):p 11, June 2023. | DOI: 10.1097/01.NAJ.0000938672.45289.82
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Study finds dramatic increase in opioid-related fatalities.

Researchers examining pharmaceutical-related pediatric deaths found that opioid-related fatalities more than doubled between 2005 and 2018. Their findings were based on an analysis of 731 reported deaths in children ages five years and younger from 40 states participating in the National Fatality Review Case Reporting System.

The research team chose to focus on young children because they had the highest number of reported poisonings and accounted for most ED visits for unintentional drug-related poisonings. Within this cohort, more than two-fifths (42.1%) of deaths occurred in children ages one year or younger, and most occurred in the home.

Opioids overall were the most common contributors to death followed by over-the-counter cold, pain, and allergy medicines. The proportion of deaths attributed to opioids jumped from 24.2% to 52.2% over the 13-year study period. Amphetamine overdoses were more common in infants (under age one), but cocaine and alcohol were also significant contributors to fatalities. About one-third of cases involved someone other than a parent supervising the child at the time they were poisoned, and one-sixth of cases were in children with open child protective services investigations, according to the researchers.

“These data highlight the increasing impact of the opioid epidemic on children and is in line with previous studies, which have described increasing rates of pediatric opioid exposures and death,” the researchers noted, adding that prevention efforts must be multifaceted and include provider, family, and public education.

An earlier study found that neglect may have contributed to numerous pediatric deaths from ingestion of over-the-counter cough and cold medications. Among the pediatric poisoning deaths reviewed in the study, 17.5% were classified as intentional (drugs were used to sedate the child) although the researchers noted that this is likely an underestimate.

How nurses can help. Nurses can take a proactive role in helping to prevent unintentional overdoses in children, including education on safe methods for storing over-the-counter or prescription medications, such as cough and cold remedies, as well as alcohol, marijuana, or illicit drugs.

The American Academy of Pediatrics recommends actively including patients and families in safety education throughout the care process, and building into this learning “culture” ethnic, language, and health literacy considerations. And, given the surge in opioid-related pediatric deaths, nurses and other clinicians should inform parents and caregivers about the over-the-counter availability of naloxone, and encourage them to have it available in the home.—Liz Seegert


Gaw CE, et al. Pediatrics 2023;151(4):e2022059016; Halmo LS, et al. Pediatrics 2021;148(5): e2020049536.
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