The opioid epidemic and minors

Find out how the ongoing opioid epidemic affects children and teens. Learn how parents can mitigate risks of opioid misuse for their family.

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Arthur Robin Williams, MD

It’s well known that the opioid epidemic is an ongoing crisis affecting millions across the country and costing tens of thousands of lives yearly. Most discussions of the crisis revolve around adults, who comprise the vast majority of victims of the opioid epidemic. Still, the children of the opioid crisis are also facing fatal consequences from the use, misuse, and prescription of opioids of all types. 

Teens are being increasingly exposed to opioids, with both prescription and illicit and teen overdoses are growing. Additionally, a recent study from the American Academy of Pediatrics (AAP) found that, of all fatal poisonings in children between 2005 and 2018, opioids were the number one cause of death. Understanding how the opioid crisis impacts children can be vital to help prevent further harm.

Opioid poisoning and death in children

Prescription and over-the-counter drugs are essential tools in modern health and medicine, but these sensitive substances must be used and dosed correctly. With many medications, the difference between a safe dose for an adult and a child is large, and most medications are dosed for adults by default. When a child accidentally uses a medicine intended for an adult, the results can easily be fatal. This isn’t only true for opioids; common painkillers and cold medication can easily harm children.

The American Academy of Pediatrics found that between 2005 and 2018, 731 children between zero and five died of unintentional poisoning. Over 40% of these children were under one year of age, and 65% happened in the child’s home. During this time, opioids accounted for 47% of fatalities, and the yearly percentage increased drastically over the next 14 years. In 2005, opioids were involved in 24% of unintentional poisoning deaths in children, and by 2018, that number had grown to 52%.

Opioids in the home are a clear and present danger to children, who can get their hands on the drugs in many different ways. Child-proof medicine bottles are not 100% effective, and children can and will gain access to them. It’s also easy for children to get ahold of prescriptions that haven’t been appropriately disposed of or left open and unattended. To reduce poisoning in children, it is crucial to reduce the presence of opioids in the home when possible.

The prevalence and problem of teen overdose

Teens are also at severe risk due to the opioid crisis. Between 2019 and 2021, fatal overdoses in adolescents aged 10 to 19 increased by 109%, and deaths involving illicitly manufactured fentanyl (IMFs) increased by 182%. These numbers account for over 2,000 deaths among adolescents. These overdoses often happen in the child’s home or near bystanders. The data make it clear that teen overdose is a growing problem. 

Opioid addiction and overdose in children and teens aren’t always the result of illicit use. Many teens are prescribed opioids as treatment for surgeries ranging from treatment of broken bones and removal of wisdom teeth. Because opioids mimic endorphins and cause euphoria, they become easy to use recreationally, and teens with access to leftover prescriptions may be tempted to take them for their euphoric effects. 

Over the past decade, medication-assisted treatment (MAT) has become well recognized for its ability to treat the physical symptoms of opioid use disorder (OUD), drastically decrease instances of overdose, and reduce the risk of relapse. However, the AAP has found that buprenorphine treatment (a critical step in MAT) is tremendously under-utilized in minors. The drug is approved for children aged 16 and older, but the number of children undergoing treatment has declined by 45%, even while its use in adults has increased during the same period. 

How families can mitigate risk to their children

As the opioid epidemic rages on, it becomes increasingly important for parents and family members of children to do everything they can to reduce the risk of opioid misuse in minors and prepare children to know what to do in the face of addiction and overdose. Talking to children about drug use and addiction is crucial, especially if a sibling or family member is dealing with OUD. Children with siblings experiencing OUD face a lot of stress and must be given the tools to emotionally manage the situation. It’s essential to be honest with everyone in your family about what is happening and keep open lines of communication about the family’s path to recovery.

It’s also important to teach your children critical harm reduction approaches such as recognizing the symptoms of an overdose and applying life-saving naloxone. If possible, keep emergency naloxone in your home and on your person at all times. You may even want to allow your older children to carry some, especially if they have friends or classmates known to use opioids recreationally. These steps can help reduce teen overdose fatalities and keep your family and acquaintances safe.

Finally, ensure that your family promptly and appropriately disposes of all leftover opioid prescriptions after surgeries and treatments. While anyone in the home is actively using prescription opioids for ongoing treatment, all adults need to be diligent about adequately closing pill containers and storing them in hard-to-access areas. These steps will help prevent accidental poisoning in children.


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