Children have an increased chance of drug overdose when their mothers are prescribed opioids, a study published in Pediatrics reports. Young children had more than twice the risk for overdose compared to children whose mothers were prescribed nonsteroidal anti-inflammatory drugs (NSAIDs) rather than opioids.
The researchers identified children aged 10 years old and younger whose mothers received subsidized prescriptions for an opioid or NSAID in the previous year. They used the public drug benefit database to compile data from 2002 to 2015 in Ontario, Canada. Out of the children identified, 103 were presented to a hospital with opioid overdose. The researchers then matched each child by age and sex with 4 controls in a non-overdose group.
Through conditional logistic regression analysis, the researchers noted that children whose mothers were prescribed an opioid were far more likely to overdose. The drugs most commonly reported in the overdoses were cocaine (53.4%), oxycodone (32%), and methadone (15.5%). None of the overdoses were fatal.
The median age was 2 years old, and 9 of the overdoses were seen in infants younger than 1 year. These findings suggest that some cases may have been a result of caregiver neglect, error, or malice.
The researchers concluded that providers serve an important role in assuring safety in patients who are prescribed opioids. Prescribers can opt for alternatives or prescribe smaller quantities of opioids when appropriate, and providers can counsel families on safe drug storage and pill disposal.
Finkelstein Y, Macdonald EM, Gonzalez A, et al. Overdose Risk in Young Children of Women Prescribed Opioids. Pediatrics. 2017, e20162887.