Fatal overdoses of fentanyl have soared in the US in recent years, and new research shows that the number of deaths among children has increased significantly, reflecting trends among adults.
According to data published Monday in JAMA Pediatrics, more than 5,000 children and teens have died from fentanyl overdoses over the past two decades. More than half of those deaths occurred in the first two years of the COVID-19 pandemic.
In 2021, there were approximately 1,550 pediatric deaths from fentanyl — more than 30 times more than in 2013, when the wave of synthetic opioid overdose deaths began in the US.
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An increase that began in 2018 led to a nearly three-fold increase in deaths among older adolescents and a nearly six-fold increase among children under age 5. In 2021, 40 babies and 93 children aged 1 to 4 years died from a fentanyl overdose.
However, since 1999, the vast majority of childhood deaths from fentanyl have been among teens ages 15 to 19.
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“In older teens, the way the poisonings happen is similar to what happens in adults. It’s recreational drug use and then they take fentanyl on purpose or it’s cut into the drugs they’re taking,” said Julie Gaither, assistant professor of pediatrics at the Yale School of Medicine, who wrote the new research letter. “That’s a story that’s much easier to understand.”
For younger children, it’s harder to get to grips with exactly what’s going on in the home — the most common place where overdose deaths occur — but it often has to do with drugs left within reach.
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“With fentanyl. I mean, it’s so powerful it doesn’t take much for them to take a lethal dose,” she said.
The number of fatal poisonings in children under age 5 had declined since the passage of the Poison Prevention Packaging Act in 1970, when harder-to-open child-resistant packaging became a standard for many drugs, other studies have shown.
But illicit drugs like fentanyl, which is 100 times stronger than morphine and can kill quickly, don’t come in child-resistant packages.
The Covid-19 pandemic also exacerbated the drug epidemic, with overdose deaths reaching record highs in 2021. Fentanyl has been implicated in about two-thirds of total overdose deaths for people of all ages.
According to the U.S. Centers for Disease Control and Prevention, multiple drugs can be listed on a single death certificate, and fentanyl is often found along with others.
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Among children and teens, benzodiazepines — medications commonly prescribed to treat conditions such as anxiety and insomnia — as well as cocaine or psychostimulants were also taken more than a third of the time, according to the new study.
These trends suggest that the “pediatric opioid crisis is changing in ways that make it more difficult to combat,” Gaither said.
Combating the crisis requires preventive measures, such as safe storage and disposal of opioids that prevent exposure, as well as harm reduction strategies, including treatment of opioid use disorders for both parents and adolescents, and increased access to the overdose drug naloxone in homes , she said. .
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