Study: Opioid poisoning deaths rising disproportionately in infants, young children

Opioids were the most common substance contributing to death of children age 5 and younger who died of poisoning between 2005 and 2018, followed by over-the-counter pain, cold and allergy medications, according to a study, “Characteristics of Fatal Poisonings Among Infants and Young Children in the United States.”

The study, published in the April 2023 Pediatrics (published online March 8), found that opioids accounted for 52 percent of poisoning-related deaths of children 5 and younger in 2018 – up from 24 percent in 2005.

Researchers analyzed data where cause of death was attributed to a “poisoning, overdose or acute intoxication” that was provided by the U.S. National Center for Fatality Review and Prevention. Infants accounted for 42 percent of 731 poisoning-related fatalities reported in Child Death Reviews nationwide.

Three-fifths of poisoning fatalities occurred in a child’s home, and approximately one-third were supervised by an individual other than the biological parent at the time of incident.

The authors cite research that finds that within the past decade, children have been exposed to new opioid sources — heroin, fentanyl and opioids used in medication-assisted treatment (e.g., methadone, buprenorphine) — which have partially reversed prior public health gains. Medication safety initiatives, such as the adoption of unit dose packaging, have shown promise in reducing exposures, but this approach does not address illicit opioids or all prescription opioids, the study notes.

The authors suggest further study is needed to improve understanding of how infants and young children can be harmed by specific types of opioids and routes of opioid exposure. They conclude that prevention of fatal pediatric poisonings will require a multifaceted approach, including improving the availability of Naloxone as well as community-level interventions, particularly among communities facing socioeconomic disparities.