Painkiller Overdose Epidemic Spreading to Teens, CDC Says

April 16, 2012

April 16, 2012 — For America's older teens, prescription painkillers are more and more becoming simply killers.

Fatal overdoses of prescription analgesics are the main reason why accidental poisoning deaths among teens aged 15 through 19 years have climbed 91% from 2000 to 2009, according to a new report on unintentional injury deaths among young people released today by the US Centers for Disease Control and Prevention (CDC).

Abuse of opioids and other pain relievers has become so rampant among older teens that "there seems to be a trend for prescription painkillers almost to replace marijuana as a [gateway] drug for substance abuse such as heroin," said Julie Gilchrist, MD, a medical epidemiologist in the CDC's Division of Unintentional Injury Prevention, in a news conference today.

The CDC has described prescription painkiller overdoses as a public health epidemic. The new findings on young people, which the CDC published in its latest Morbidity and Mortality Weekly Report (MMWR), show that the problem is not confined to adults, said Dr. Gilchrist.

"It's tragic to see this epidemic beginning in our young people," she said.

The CDC lacks hard data on exactly where teens are obtaining prescription painkillers. Teens most likely are filching these drugs from the family medicine cabinet as well as buying them on the street, said Dr. Gilchrist.

Childhood Injuries Are Largely Preventable, Like Measles

The disturbing statistics about accidental poisonings exemplify how there is ample room for improvement in an otherwise encouraging CDC report on unintentional injury deaths among Americans aged 19 years and younger. The overall rate of such deaths per 100,000 people declined from 15.5 in 2000 to 11 in 2009. Likewise, the sheer number of deaths decreased from 12,441 to 9143 during that timeframe.

Accounting for most of that decrease was a 41% decline in the rate of motor vehicle–related deaths, which reflected, among other things, improved use of seat belts, child safety seats, and booster seats; better vehicle design; and limited driver's license privileges for teens, according to the CDC. However, motor vehicle crashes still represent the leading cause of accidental childhood death.

Another area of concern besides accidental poisoning was a 54% increase in the rate of unintentional infant suffocation deaths, which stood at 1.4 per 100,000 people in 2009. Dr. Gilchrist said parents should follow infant-sleep guidelines set forth last year by the American Academy of Pediatrics (AAP). These include placing infants on their back every time; using a crib with a firm sleep surface and no loose bedding or toys inside; and sharing a room, but not a bed, with infants "to avoid lay-overs and wedging in between the mattress and the wall, and all the other tragic things that can happen," she said.

Eliminating wide state-to-state variation in accidental childhood deaths could save even more lives, according to the CDC. The rate of unintentional injury deaths per 100,000 in Mississippi in 2009, for example, was 25.1, more than 6 times that in Massachusetts. Dr. Gilchrist attributes the lower rates in states such as Massachusetts to a greater investment in preventive policies and programs that range from teen driving laws to safer playgrounds.

Despite improvements reported in the new MMWR, accidental injuries are still the leading cause of childhood death, says the CDC. Accordingly, the agency today released a National Action Plan for Child Injury Prevention that aims to mobilize a national campaign to reduce such mishaps. It was developed in conjunction with 60 other stakeholder groups, including the AAP, children's' hospitals, and the Association of State and Territorial Health Officers.

In today's press conference, Dr. Gilchrist stressed that childhood injuries are largely preventable. There is a temptation, however, to take them for granted, as if they were a rite of passage.

"Most kids do survive, but there is a significant number who do not," she said. "We're trying to make sure we don't take that for granted, and that injuries are dealt with in terms of prevention, very similar to the way we deal with measles…and other kinds of conditions."

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