Non-fatal drug overdoses in children under 15 on the rise, study finds

While overall drug overdoses among youth are infrequent, non-fatal overdoses were on the rise in children under the age of 15 between 2016 and 2019, a new study finds.

The rise appears to be driven by stimulants such as cocaine and amphetamines like meth and ecstasy, according to the study published Monday in the journal Pediatrics.

If the trend continued into 2020, it could be a wake-up call for parents, as drug overdoses appear to be on the rise during the pandemic.

“More than 40 states have reported increases in opioid-related mortality as well as ongoing concerns for those with a mental illness or substance use disorder,” said the American Medical Association (AMA) in a recent issue brief.

Analysis of emergency room data

Researchers from the National Center for Injury Prevention and Control, a part of the US Centers for Disease Control and Prevention, analyzed nearly 90 million emergency room visits for youth up to age 24 between April 2016 and September 2019.

The analysis was broken down by age groups: Children from birth to 10 years old; youth aged 11 to 14; and teens and young adults aged 15 to 24.

Stimulant-associated overdoses were on the rise among all three age groups, the study found, when measured as an average quarterly percent change over the three and a half year period. The authors note a parallel rise in stimulant use in the adult population.

There was one piece of good news: Suspected heroin overdoses among 15- to 24-year-olds declined during the same time frame.

“Although further research is needed to both indicate if these patterns are continuing and to identify the specific drugs driving the increases, our results suggest that targeted interventions, even with young children, such as multifaceted approaches including school, family, and medical providers may be warranted to prevent overdoses requiring medical treatment,” wrote lead author Douglas Roehler, an epidemiologist at the CDC.

Difference by age groups

Among children from birth to 10 years old, the study found there was an average of 22.3 drug overdoses per 10,000 emergency room visits. The rate for youth aged 11 to 14 years old was nearly double at 43.2 overdoses per 10,000 visits, nearly doubling again for young people aged 15 to 24 years at a rate of 85.2 drug overdoses per 10,000 visits.

“Despite the rarity of these suspected overdoses and given the age of these patients and the likely unintentional nature in many of these cases, efforts to halt these increasing trends are important,” Roehler and his colleagues wrote.

For children from birth to 10 years old, the rate of drug overdoses involving all drugs rose 2% on average per quarter for overdoses involving all drugs. When broken down by drug type, there was an average increase of 1.5% in the rate of opioid involved overdoses per quarter, and an average increase of 3.3% per quarter for stimulant involved overdoses.

For children 11 to 14 years old, the rate of drug overdoses involving all drugs rose an average of 2.3% per quarter. When broken down by drug type, the average quarterly rate increase was 1.9% for opioid involved overdoses, and 4.3% for stimulant involved overdoses.

The rate of drug overdoses from all drugs actually dropped in the group of young people ages 15 to 24, at an average of -0.4% per quarter. When broken down by drug type, overdoses involving opioids dropped -0.6% on average per quarter, while the rate of overdoses involving heroin decreased an average of -3.3% per quarter.

However, the rate of stimulant involved overdoses for the same age group increased in that same time period at an average of 2.3% per quarter.

Advice for parents

Parents can help prevent an overdose by their child by following these key steps, according to the Partnership for Drug-Free Kids.

Keep prescription pain pills out of your home. Keep any pills you must use securely locked away, and discard them when you are finished with your pain management.

“While it may be tempting to keep pain medications ‘just in case you might need them,’ the safer course of action is to dispose of all expired or unused medication since family and friends are the primary source of prescription pain pills,” the association advised.

Keep talking. Ongoing, in-depth conversations with your teen or young adult about the risks of substance use, including prescription medication, opioids and stimulants, may help your child understand the pitfalls of chasing a high.

Find alternatives. Ask your doctor to help you find non-opioid alternatives to manage your child’s pain from injuries, surgeries, dental work and other situations where pain management is needed. This is especially critical if a child is a known user.

Learn the signs. There are a number of signs that can point to substance abuse, including:

• Fatigue, drowsiness and changes in sleep patterns
• Pinpoint pupils and dark circles under the eyes
• Rapid weight loss
• Deterioration of hygiene or personal appearance
• Health complaints such as being constipated or experiencing nausea
• Isolating from family and friends or a change in friends
• Skipping school or work and drop in grades or performance
• Mood changes such as agitation, increasing depression or anxiety and a lack of interest in hobbies and recreational activities
• Asking for more money for questionable reasons or missing money or valuables
• Wearing long sleeved shirts in warm weather (could be associated with IV use)
• Missing or empty prescription pill bottles or prescriptions filled at the pharmacy without your knowledge
• Paraphernalia used to prepare drugs for consumption, such as syringes or hypodermic needles, shoelaces or a piece of rubber hose or string, bottle caps and kitchen spoons, cotton balls, cigarette filters, aluminum foil, lighters or candles and straws

Reach for help. Get an evaluation to determine your treatment options if your child is misusing prescription medications, opioids and stimulants.

“Comprehensive, evidence-based treatment works —the earlier you intervene and take action, the better,” the Partnership for Drug-Free Kids said.

Be prepared. Obtain and learn how to use Naloxone (Narcan®) as a precautionary measure against overdose.

“You should always have Naloxone available to both you and your child, just in case, as you would a first-aid kit,” the the Partnership for Drug-Free Kids suggested. “It can be purchased at most pharmacies or acquired through community organizations offering training and free kits.”