U.S. Teen Opioid Deaths Soaring
TUESDAY, April 30, 2019 (Pharmacist's Briefing) -- The number of American children and teens who have lost their lives to opioids has nearly tripled since 1999, a new report shows.
Based on data gathered by the U.S. Centers for Disease Control and Prevention, the investigators found that the misuse of painkillers and/or illicit opioids (heroin and fentanyl) claimed the lives of nearly 9,000 American youths between 1999 and 2016.
Fatalities rose particularly sharply between 2013 and 2016, when some parts of the country saw five times the number of youth succumbing to opioids.
"While every region of the country has seen an increase in pediatric deaths from opioids, certain regions of the country have been hit particularly hard," said lead study author Julie Gaither, an instructor in the department of pediatrics at Yale University.
For example, while opioid-related death rates among Americans under the age of 20 were highest in the Northeast in both 1999 and 2016, the death rate most rapidly increased in the Midwest, which saw an under-20 fatality jump of nearly 430%.
By contrast, the West only experienced a doubling of its pediatric death rate during the same time frame.
Why the difference?
"This remains an open question," Gaither said. "Unfortunately, we know little about the circumstances behind fatal opioid poisonings in kids. The vast majority of research on opioid deaths has focused on adults."
But Linda Richter, director of policy research and analysis with the Center on Addiction in New York City, said the findings "are highly consistent with overall regional differences in opioid misuse, addiction, overdose and deaths in the United States.
"Drug epidemics," she explained, "are often regional, and the opioid epidemic has primarily hit the Northeast and Midwest due to drug trafficking routes," with the West exposed to a smaller supply of illicit opioids from regional drug cartels.
"[So], the opioid epidemic has hit the Northeast the hardest, and has been spreading in recent years to the Midwest, as the illegal drug market has begun to hit that region," Richter added.
Gaither added that there are regional differences in the availability of nalaxone (Narcan) -- a prescription drug that rapidly reverses an opioid overdose in progress.
While the higher death rate has a lot to do with the rising use of heroin and painkillers among teens, the team found wide regional differences in that regard.
For example, heroin was the biggest culprit in the Northeast, at the root of nearly a third of all opioid deaths. But in the South it was the least implicated root cause, accounting for only about 18% of deaths.
Similarly, synthetic opioids (mostly fentanyl), were implicated in nearly 18% of pediatric opioid deaths in the Northeast, but just 9% in the South.
In contrast, "the West has not been as affected by these trends, as have other regions of the country," Gaither said.
"What we do know is that opioids are in virtually every American home, and children are increasingly growing up with parents who are either using or misusing opioids," she said. "Therefore, children now have greater chance of being exposed to the drugs than in the past."
And Richter warned that "the more accessible these drugs are, the more likely kids are to try them, either intentionally to get high or, for younger kids, unintentionally because of curiosity or a tendency to put things in their mouths."
To tackle the issue, Gaither argues that "parents need to be told how to store the medications and what to do with them when they are no longer needed."
She also suggested that physicians, nurses and pharmacists "should begin to more widely consider whether their adult patients have children in the home, and educate them accordingly."
The findings were recently presented at the Pediatric Academic Societies annual meeting, in Baltimore. Research presented at meetings is considered preliminary until published in a peer-reviewed journal.
The U.S. Centers for Disease Control and Prevention offers more details about opioids.