Claire Foster Blog

The good news: more people with substance use disorder are able access medication-assisted treatment (MAT), such as methadone and buprenorphine. The bad news: a new study notes that young children are exposed to the medications, which has led to thousands of unintentional poisonings. Correlating with the increased availability of MAT, child exposure to these medications has also increased by 215% in three years.

Dr. Jason Kane, an associate professor of pediatrics and critical care at University of Chicago Medicine Comer Children’s Hospital told CNN that the exposure was accidental, not a sign of a new epidemic. “This burden we’re putting on the healthcare system is entirely preventable,” Kane told CNN. “These are children who do not need a hospital if not but for the fact that they were accidentally poisoned by medications that were not designed to be taken by them.”

According to the study, which focused on 11,275 children who’d been exposed to MAT, “the overall exposure rate per 1 million increased by 215.6% from 2007 to 2010 (from 6.4 to 20.2), followed by a 42.6% decline from 2010 to 11.6 in 2013, before increasing by 8.6% to 12.6 in 2016.” That increase mirrors the climbing rates of substance dependency, and the number of people seeking treatment. More MAT prescriptions means more potential accidents, which is why parents and other adults need to be extremely careful about securing medication.

The study suggested that, since about 2.1 million people in the United States have an opioid use disorder and 11.5 million are reported as misusing prescription opioids, it makes sense that the number of children and adolescents who are exposed to buprenorphine will continue to rise.

“You’d be hiding under a rock if you didn’t realize there’s a big opioid crisis going on, and this is one of the treatments for that addiction,” said the study’s author Henry Spiller, director of the Central Ohio Poison Center. “A number of these programs are trying to expand to accommodate a lot of these opiate-addicted patients, so I would expect to see more of this.”

The study was careful to distinguish between accidental use and intentional use by young people. It’s one thing for a kindergartener to get their hands on a few buprenorphine pills that are left on a coffee table. It’s another for a teenager to deliberately take it from the family medicine cabinet. According to the study, adolescents made up just 11% of total exposures, but 77% of those exposures were intentional (with 12% suspected suicides). More than 25% of adolescents used buprenorphine with at least one other substance.

CNN pointed out that there was a gender divide within the deliberate MAT misuse. “Though more than 60% of the buprenorphine abuse and/or misuse was in male adolescents, female adolescents accounted for almost 60% of the suspected suicides within this group, the authors note.”

“It was surprising that adolescents were actually using it for abuse. It’s very specific,” Spiller said. “You have to be in a program to get this. It’s carefully managed. It’s not widely available. … It is available on the street, but essentially, the majority of this is from these management programs and someone’s in therapy, someone in the house, them or a family member.”

Keeping medications away from children is important. Common sense precautions that can help protect kids include include disposing of any unused medications, keeping child-proof caps on containers and leaving medications in their properly labeled boxes or bottles. The approval of a buprenorphine subcutaneous implant in 2016 may also reduce children’s access: patients with an implant would not have pills for children to get into.

Kane told CNN, “Seven children under the age of 6 died as a result of an accidental poisoning from this drug, which was present in someone’s home, prescribed with the goal of making someone else better. That’s a striking thing for me.”