NEW YORK: More than 11,200 calls about children's exposure to buprenorphine, an opioid drug used to treat opioid use disorder, were conducted at the US poison control centers. UU Between 2007 and 2016, he found a new study. Eighty-six percent of the exposures were in children under 6 years of age; 89% of the exposures were not intentional.
"This is never prescribed for children under the age of 6. It's a significant risk to them," said Henry Spiller, director of the Central Ohio Poison Center and author of the study, published Monday. in the academic journal. "We're not sure why it stands out so much, maybe parents who have this may think it's not as risky as their other opioids because it does not have the great effect that the other opioids do for them ," he said. reference to medication that is left out or within reach of children who then test it.
Experts see these numbers as an unintended consequence of medical therapy being provided to those who need it, said Dr. Jason Kane, an badociate professor of pediatrics and intensive care at the University of Chicago Medicine Eating Children & # 39; s Hospital.
Among the 11,275 children exposed, the global exposure rate per 1 million increased by 215.6% from 2007 to 2010 (from 6.4 to 20.2), followed by a decrease from 42.6% in 2010 to 11.6 in 2013, before increasing in 8.6% to 12.6 in 2016.
"This is not the first study to show this data, but it is the latest study to show a drug whose design is to help adults with narcotic or opiate addiction to end poisoning, mostly only rarely, children and particularly those who are most vulnerable, "said Kane, who was not involved in the new research, but led a recent study that found that the number of opioid overdoses among children was almost it had doubled since 2004.
Buprenorphine is an opioid receptor stimulant and a blocker, explained Spiller, who is also a diplomat for the American Board of Toxicology. As a result, it does not provide the same "high" as other opiates, but it remains an opiate.
"In adults, respiratory depression, the part that reduces breathing and stops breathing, is limited, and then there is much less respiratory depression in adults," Spiller said. "That's why he felt more secure." Unfortunately, in very young children under 5, preschoolers, young children, infants … that protection is not there, and they do have this respiratory depression. It affects the breathing. "
Teens may not have the same risk as 5-year-olds, but they are not immune," he added. "Significant real effects are additive. They get worse when you start adding things like alcohol, maybe another medicine, other things. "
In fact, although adolescents constituted only 11% of total exposures, 77% of those exposures were intentional (with 12% of suspected suicides), and more than 25% used buprenorphine with at least one other substance, according to the study.
"It was surprising that adolescents actually used it for abuse. It's very specific, "said Spiller." You have to be in a program to get this. It is carefully administered. It is not widely available. … It's available on the street, but essentially, most of this is from these management programs and someone is in therapy, someone in the house, they or a family member. "
Although more than 60% of abuse of buprenorphine and misuse was in male adolescents, adolescent females accounted for almost 60% of suspected suicides within this group, the authors note.
"In adolescents, there is a risk in which we begin to see an increased risk of suicide attempts, only as part of adolescence, "Spiller said." But if this is at home, this is a really potent drug. "They may try to add this or use it as any drug they are using to suicide attempts. "
The authors of the study expect that with approximately 2.1 million people in the United States having an opioid use disorder and 11.5 million abusing prescription opioids, the number of children and adolescents who are exposed to buprenorphine will continue to increase.
"You would hide under a rock if you did not realize that there is a great crisis of opiates, and this is one of the treatments for that addiction," Spiller said. "Several of these programs are trying to expand to accommodate many of these patients addicted to opioids, so I would expect to see more of this."
Almost a quarter of children under the age of 6 who are exposed spend intensive care time, Kane noted.
"This burden we are putting on the health care system is completely preventable," he said. "These are children who do not need a hospital if they are not, due to the fact that they were accidentally poisoned with medications that were not designed to be taken by them."
The authors of the study recommend the prevention of exposure aligned with the age group of children. For example, packaging unit doses of manufacturing instead of a whole bottle of pills would help prevent inadvertent exposure among young children, while blocking medications on a shelf can help keep teens out.
The approval of a subcutaneous buprenorphine implant in 2016 also reduces children's access, the study said because patients with an implant would not have pills for children.
Other suggestions include getting rid of the unused medications, keeping the childproof caps on the containers and leaving the medications on their labels. Kane said that "Seven children under the age of 6 died as a result of accidental poisoning of this medication. drug, which was present in someone's home, prescribed for the purpose of improving another person, "Kane said. and added: "that's something surprising to me"