Drug used to treat opioid dependence poses serious health risks in exposed children

A new study published online today by Pediatrics and conducted by researchers at the Center for Injury Research and Policy and the Central Ohio Poison Center at Nationwide Children's Hospital found that from January 2007 through December 2016 there were more than 11,000 calls to US Poison Centers for pediatric exposures to buprenorphine – a prescription opioid medication used to treat opioid use disorder.

Most (86%) of the calls were about exposures among children younger than 6 years old. Most (98%) buprenorphine exposures among younger children were unintentional. Nearly half (45%) of the exposures resulted in the child being admitted to a healthcare facility and 21% resulted in serious medical outcomes, including 11 deaths. The most common symptoms for buprenorphine alone were drowsiness/lethargy (47%) and vomiting (17%).

While most buprenorphine exposures among younger children were unintentional, 77% of exposures among teenagers (age 13-19 years) were intentional and 28% involved more than one substance. More than one-fifth of teen exposures resulted in being admitted to a healthcare facility, and 22% experienced a serious medical outcome, including 4 deaths. There were 150 suspected teen suicide attempts, 59% of which involved at least one other drug.

"Buprenorphine is an important medication for the treatment of opioid use disorder among teenagers and adults," said Gary Smith, MD, DrPH, senior author of the study and director of the Center for Injury Research and Policy at Nationwide Children's Hospital. "But it can cause decreased breathing and death if a young child swallows it. That is why all buprenorphine products should use unit-dose packaging to help prevent unintentional access by young children."

"Safe storage of all opioids, including buprenorphine, is vital," said Henry Spiller, MS, D.ABAT, study author, and director of the Central Ohio Poison Center. "Parents and caregivers who take buprenorphine need to store it safely: up, away, and out of sight – in a locked cabinet is best. Additionally, there is rising concern of adolescents abusing buprenorphine."

Data for this study were obtained from the National Poison Data System, which is maintained by the American Association of Poison Control Centers (AAPCC). The AAPCC receives data on calls to regional poison control centers that serve the US and its territories. Poison control centers receive phone calls through the Poison Help Line and document information about the product involved, route of exposure, individual exposed, exposure scenario, and other data.