Overdose Risk in Young Children of Women Prescribed Opioids

Peter M. Yellowlees, MBBS, MD


July 11, 2017

This is the Medscape Psychiatry Minute. I'm Dr Peter Yellowlees.

Over the past 20 years, the prescribing of opioids has increased dramatically in North America, with parallel tragic increases in opioid addiction, overdose, and associated deaths. Now a team of investigators[1] from the University of Toronto, Canada, have examined whether young children of women prescribed opioids are at increased risk for opioid overdose. The researchers conducted a population-based, nested case-control study in Ontario, Canada, between 2002 and 2015. Cases were children aged 10 years or less, whose mothers received prescriptions for an opioid or a nonsteroidal anti-inflammatory drug (comparator analgesic) in the preceding year and who presented to hospital for, who or died of, opioid overdose. One hundred and three cases were matched with 412 controls with no opioid overdose. The researchers found that half of the children with opioid overdose were younger than 2 years old and that they were far more likely to have a mother who received a prescription for opioids, namely codeine (53%), oxycodone (32%), and methadone (15%).

This is a vitally important study for all clinicians and is a tragic consequence of our current opioid epidemic. It is not surprising that young children of mothers prescribed opioids are at a markedly increased risk for overdose and are dying completely unnecessarily. We can prevent this. All physicians should take measures to mitigate the risk for opioid-related harm to children, such as prescribing smaller quantities, emphasizing the importance of secure medication storage, and the prompt disposal of unused opioids. And if you know of a colleague who you believe is not prescribing carefully, speak to them and show them this video. We have to stop these preventable deaths.

Thank you for listening to this Medscape Psychiatry Minute. Do enjoy your practice.


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