This Lifesaving Opioid Addiction Treatment Is Putting Kids At Risk

More kids are ingesting buprenorphine, a medication usually used by addicts trying to get clean

A pharmacist fills a Suboxone prescription . — REUTERS
Mar 20, 2017 at 4:29 PM ET

Although buprenorphine, the main ingredient in opioid replacement medications such as Suboxone and Subutex, has helped countless addicts wean themselves off more deadly opioids, a new study has found that the medication is increasingly finding itself in the hands of children — with dangerous results.

In a new study set to publish online in the journal Pediatrics, researchers analyzed more than 188,000 calls to poison control centers made between 2005 and 2015 that dealt with child exposure to opioid substances in kids under the age of 20. Perhaps unsurprisingly, the first few years of the study saw an increase of 86 percent of opioid exposures to children. After 2009, researchers recorded a decline of almost 32 percent, barring one exception: buprenorphine. Instead, buprenorphine exposures increased from 2014 to 2015 after declining from 2011 to 2013. Additionally, children aged zero to five years accounted for almost 90 percent of buprenorphine exposures during the study.

“Counter to the decline in exposures to other types of opioids, we actually saw a pretty significant increase in exposures to buprenorphine during the last two years of the study among children,” Marcel Casavant, the medical director of the Central Ohio Poison Center at Nationwide Children’s Hospital and author of the study, said in a statement. “Calls to poison control centers regarding buprenorphine continue to climb.”

Almost half of children exposed to buprenorphine were admitted to a health care facility, the study reported. Overall among children exposed to prescription opioids, 6.6 percent experienced serious medical outcomes, including 175 fatalities. Of the children who died, more than half were teenagers.

Speaking to Vocativ on Monday, Casavant was hard-pressed to explain why childhood buprenorphine exposure is on the rise. Medications such as Suboxone, which is a combination of buprenorphine and naloxone, an opioid blocker, are often sold as dissolvable strips or sublingual tablets which take more than a few minutes to fully enter a user’s system. Even still, Casavant said that even when parents removed a buprenorphine-containing medication from a child’s mouth quickly, they would still have to call poison control because the child would be exhibiting symptoms of opiate overdose.

“There is something about the ability of the mucus membrane of the mouth to absorb this before it’s swallowed,” Casavant told Vocativ. “We do see these poisoning situations interrupted, and yet the children go on to have symptoms.”

Further, buprenorphine has over the last few years become a preferred replacement therapy for recovering addicts over methadone, partly because it is seen as safer and partly because patients are permitted to take their doses at home rather than spend hours everyday at a methadone clinic waiting for their daily dose.

“By far, buprenorphine is much safer than methadone, particularly for the folks that have been addicted to opiates and have that kind of tolerance. That safety measure does not apply to kids, and we may forget to mention that,” Casavant says. “When the prescribers are trying to sell the patients on how much safer the drug is, I suspect sometimes they don’t mention, ‘By the way, this could be deadly to your child even if you think you’ve got it out of your child’s mouth.’”

More The Lifesaving Addiction Treatment Too Few Doctors Are Prescribing

Casavant said that many people coming out of addictions to opioids were often leading chaotic and disruptive lifestyles when they were actively using, so it might just be that people need to be much more careful about where they store their drugs, or use a lockbox to keep them out of the reach of children. However, he also said that he’s heard of managed care companies pressuring prescribers to prescribe the less-expensive tablet forms of buprenorphine over the dissolvable strips as way to save money, which could in turn be leading to kids have a greater chance of taking the medication in a life-threatening way.

Ultimately, Casavant thinks it’s really a matter of increased awareness and education.

“The folks I would most encourage to get involved are the prescribers, and to do a good job teaching, ‘If you got this medicine, it’s potentially deadly to children,’” he said. “They really need to hammer home the point that even a small taste of this could deadly to a child. I think manufacturers can help with that with the education they provide, both with the package labels and the handouts they give with the medicine.”