Children at risk of opioid overdose from parents’ prescriptions, Canadian study finds

Children whose mothers are prescribed opioids are at more than twice the normal risk of being hospitalized for opioid overdose. That’s the finding of a new study from the Institute for Clinical Evaluative Sciences (ICES) and the Hospital for Sick Children in Toronto.

Researchers combed through data on children aged ten years or younger who were treated for opioid overdose in emergency departments in Ontario between the period of 2002 and 2015. They found 103 cases where the child’s mother had in the past year received a prescription for an opioid through the provincial drug plan, representing a nearly 2.5-fold higher-then-normal risk for children whose mothers were prescribed opioids.

“With the increase in opioid prescribing and availability of these drugs in North American homes, it’s critical to understand how this may impact children,” says lead author of the study, Dr. Yaron Finkelstein, staff physician in Paediatric Emergency Medicine and Clinical Pharmacology and Toxicology and associate scientist at SickKids, in a statement from ICES.

“Prescribers, pharmacists and parents should be cognizant of this risk and take measures to prevent overdoses, such as dispensing smaller opioid quantities, considering alternatives to opioids for pain relief, and emphasizing the importance of secure storage and disposal of unused opioids,” says Dr. Finkelstein.

Researchers found that half of the children who came to emergency with an opioid overdose were two years of age or younger and one in ten overdoses involved infants under 12 months. Almost 40 per cent of the children were admitted to hospital and 13 of the 103 children were admitted to critical care units.

While thankfully none of the children died as a result of overdose, the risk is real. “For some opioids, a single tablet is enough to kill a child,” says Dr. David Juurlink, study co-author and senior scientist at ICES. “It’s important that parents and grandparents understand the importance of keeping these drugs out of the hands of young children.”

The study results show how important it is for doctors and pharmacists to impress upon patients how important it is to keep such powerful drugs safe from children in the home, says Dr. Juurlink. “It’s incumbent upon parents and grandparents to keep their pills well out of reach — ideally under lock and key, but certainly inaccessible — and simply having a child-resistant cap isn’t adequate,” says Dr. Juurlink to the Hamilton Spectator.

Canada is in the midst of an opioid crisis involving prescription drugs such as OxyContin and Hydreomorph Contin as well as illicit forms of heroin and fentanyl which are being smuggled into the country. In effort to combat the problem, Health Canada recently announced a proposal to put cigarette pack-like warning stickers on every opioid prescription.

Health Minister Jane Philpott says that her government is ready to use any tool at its disposal to try to stem what she called the nation’s greatest public health crisis and that the stickers would be one part of a multi-pronged approach, likely to come in the form of stickers on prescription bottles similar to those used to remind patients to take drugs with food.

“You don’t want to drive people to use even more harmful street drugs and illicit substances,” Philpott said to Reuters. “So it needs to be done with a tremendous amount of wisdom and thoughtfulness, and we are certainly consulting widely to make sure we don’t have any unintended consequences from our actions.”

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