Saturday, December 27, 2014

Prescription painkiller abuse: How does it affect kids?

Now considered an epidemic among adults, more children are also abusing painkillers and suffering from the health effects of abuse.

Prescription painkiller abuse: How does it affect kids?

The United States has a crisis in the abuse of prescription painkillers such as oxycodone and hydrocodone.  The rate of newborns withdrawing from painkillers or opiates – called neonatal abstinence syndrome or NAS – in the US almost tripled from 2000 to 2009 (1.2 babies per 1000 newborns to 3.4) and has gone up even more since.  The areas with the highest levels of addicted newborns are not big cities, but rural areas in states such as Kentucky and Maine, which have very limited pediatric resources to care for these sick infants. The cost of Medicaid for newborns has increased greatly because the care for NAS babies is expensive. 

At the other end of the pediatric age range, the Centers for Disease Control and Prevention estimates that there are now 10,000 extra deaths yearly from prescription opiate overdose (some obtained legally, much not) and these include many adolescents and young adults. Additionally, opiate overdose deaths in the past have been heavily male-dominated, but now over one-third are female.

Many factors contribute to the increasing abuse of prescription painkillers by kids, including greater availability. For example, the number of hydrocodone and oxycodone products prescribed legally in the United States increased from about 40 million in 1991 to nearly 180 million in 2007, according to a recent study. The Philadelphia Inquirer recently reported that one man managed to obtain 380,000 tablets of Oxycodone and Xanax from one family doctor in Philadelphia in less than two years by using a small army of accomplices recruited to pose as patients in severe pain

Finally, the U.S. Food and Drug Administration made recommendations to the federal government last month that would greatly strengthen the restrictions for obtaining prescription opiates in the face of strong opposition from pharmaceutical companies and other includings patient advocates.  These rules will make it harder for legitimate high end user of oral opiates, such as people with sickle cell disease, to obtain their medication, but the numbers of casualties from the widespread availability of these drugs is astonishing.

As mentioned above, a good deal of oral opiate abuse is happening not in the inner cities or in traditional drug markets, but in suburban and rural America.  There is at least one person selling opiates in your child’s good quality high school or college.  The mixture of even moderate doses of opiates combined with the frequent abuse of alcohol in almost all age groups is a deadly and a frequent problem.

What can you do about this critical problem?  Talk to your children about the dangers of abusing painkillers.  Keep tabs on where they go and what they do.  And don’t think, “Oh, it’s only alcohol and not something bad.” An 18-year old-sophomore at Villanova died of alcohol poisoning after a drinking binge in August. Opiates only worsen a pre-existing problem that is both personal and is systematic in American culture.


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Gary A. Emmett, M.D., F.A.A.P Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
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The Healthy Kids blog is your window into the latest news, research and advice around children's health. Learn more about our growing list of contributors here.

If you have questions about your child's health, ask them here.

Anna Nguyen Healthy Kids blog Editor
Sarah Levin Allen, Ph.D., CBIS Assistant Professor of Psychology at Philadelphia College of Osteopathic Medicine
Stephen Aronoff, M.D., M.B.A. Chair of the Department of Pediatrics at Temple University Hospital
Peter Bidey, D.O. Medical Director of Family Medicine at Philadelphia College of Osteopathic Medicine
Christopher C. Chang, MD, PhD, MBA, FAAAAI, FACAAI Associate Professor of Medicine in division of Rheumatology, Allergy and Clinical Immunology at UC Davis
Katherine K. Dahlsgaard, Ph.D. Lead Psychologist of The Anxiety Behaviors Clinic at Children's Hospital of Philadelphia
Gary A. Emmett, M.D., F.A.A.P Director of Hospital Pediatrics at TJU Hospital & Pediatrics Professor at Thomas Jefferson Univ.
Mario Cruz, M.D. Pediatrician, Associate Director of Pediatric Residency Program at St. Christopher’s Hospital for Children
Magee DeFelice, M.D. Division Chief of Allergy and Immunology at Nemours/Alfred I. duPont Hospital for Children
Hazel Guinto-Ocampo, M.D. Chief of Pediatric Emergency Services at Nemours duPont Pediatrics/Bryn Mawr Hospital
Rima Himelstein, M.D. Adolescent Medicine Specialist at Crozer-Keystone Health System
Jessica Kendorski, PhD, NCSP, BCBA-D Associate Professor in School Psychology/Applied Behavior Analysis at Philadelphia College of Osteopathic Medicine
Anita Kulick President & CEO, Educating Communities for Parenting
Janet Rosenzweig, MS, PhD, MPA VP for Programs & Research for Prevent Child Abuse America
Beth Wallace Smith, R.D. Registered Dietitian at Children's Hospital of Philadelphia
Jeanette Trella, Pharm.D Managing Director at The Poison Control Center at CHOP
W. Douglas Tynan, Ph.D., ABPP Director of Integrated Health Care for American Psychological Association
Flaura Koplin Winston, M.D., Ph.D. Scientific Director of the Children’s Hospital of Philadelphia’s Center for Injury Research and Prevention
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