Child deaths from opioids rising, say Yale researchers

We often think only of grown ups taking pills, this study reminds us children can take them too.

Photo credit: Katherine Chase on Unsplash
  • In the mist of all the news on the opioid epidemic, details of how children are affected can be buried.
  • A new report from Yale shows us the scope of the problem, and little we are doing about it.
  • While the study is grim, it does show us that progress is possible and offers a few solutions.

The United States is in the middle of one of the worst drug crises on record. In 2017 alone, 72,000 adults died from opioid overdoses. Let that number sink in, its higher than the death toll of the Vietnam war, more people than were killed by HIV/AIDS at the worst of the epidemic, greater than the population of Wilmington, Delaware.

Its also only the number for a single year.

As we deal with this crisis, the size of the numbers in front of us and the complexity of the issues often obscures the gravity of the situation. We also often focus so much on the main problem that we fail to notice the problems caused by the main issue. A gut-wrenching report seeks to fix that problem however and gives us the details on the number of children who have died in the crisis.

The toll of the opioid epidemic on children

In the first study of its kind, a group of Yale researchers investigated the number of deaths caused by opioid consumption in children and young adults under the age of 18. While other studies had included such deaths before, no known study had focused on this subject exclusively or had given it the attention it deserved.

While those previous studies had focused on the number of hospitalizations and worked backward from there, this study took a wider view that would include deaths outside a medical setting. It suggests that the actual number of children who die each year from this epidemic is closer to 500, not 30, the previous go-to estimate. This means 9000 children died as a result of the crisis between 1999 and 2016, the years the data covers. On a yearly basis, the number of deaths rises and falls in sync with the number for adults and has undergone a rapid climb over the past few years. Today the problem is three times as large as it was 20 years ago.

The vast majority of these deaths occur with non-Hispanic white male teenagers, but the number of non-white victims is rising. Worse still, 605 children under the age of four died from opioid overdoses over the time span the data covers.

What causes this? 

Eighty percent of these deaths are listed as "unintentional" and include everything from teenagers overdosing on heroin to children getting into a pill bottle. A small percentage of the deaths were also reported as suicides or homicides, but these numbers pale in comparison to the accidental deaths. A quarter of the opioid-related deaths for children, however, under five were treated as homicides.

The authors explain that very few precautions are taken to keep children away from these drugs. They give the example of Suboxone and describe the pathetic level of security the packaging has:

"... both Suboxone (the combination form of buprenorphine and naloxone), a medication used to treat opioid addiction, and Duragesic (the transdermal pain patch of fentanyl) come in foil wrappers that can be easily opened by a child. Suboxone is no longer sold in pill form because of concerns over pediatric exposures, but in its current formulation — which consists of brightly colored film strips — it still poses a danger to children."

What can we do to stop this?

The good news is, there are steps we can take to fix this. The data shows that the number of deaths declined in 2008 and 2009, corresponding to a national decrease in opioid prescriptions, before they went back up again. This suggests that action taken to reduce the overall level of opiate addiction and illicit drug use in adults can have positive effects for children.

The authors also hope their findings will be used to help improve initiatives already underway, such as programs that are making Narcan, the drug that counteracts overdoses, more available in homes and communities. Since the majority of child deaths occur outside of medical centers, the availability of this drug could have a tremendous, positive, effect if policymakers consider how to make it available to at-risk teens.

The opioid epidemic is taking a tremendous toll on Americans. The problem of how it affects children is one that we neither want to worry about nor have given enough thought to. While our national policy concerns focus on the adult victims of addiction, we must not forget that children are also affected and need help.

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