Expand chart
Reproduced from JAMA Network Open report "US National Trends in Pediatric Deaths From Prescription and Illicit Opioids, 1999-2016"; Chart: Axios Visuals

The death rate of children and teenagers from opioid poisoning almost tripled between 1999 and 2016, with nearly three quarters of them from prescription medicines, an analysis of national data published in JAMA Network Open Friday shows.

By the numbers: Almost 9,000 people in the U.S. under 20 died over the 18-year period — including a surprisingly large number of 0-5 year olds and a growing number of 15–19 year olds, study author Julie Gaither tells Axios.

"This study really speaks to how all segments of U.S. society have been affected. No one has been spared. And, there's no sign to date that this is going to change."
— Julie Gaither, instructor, Yale School of Medicine

What they did: The researchers examined death certificates from the Centers for Disease Control and Prevention for children and adolescents who died from opioid poisonings with prescription and illicit drugs during that time period. While certificates can sometimes misclassify deaths, Gaither says the numbers are likely underreported.

What they found: "About 500 children per year are dying from opioid poisoning," Gaither says, and that number is growing. This tracks the same team's findings in a 2016 study on opioid-related hospitalizations for youth.

  • Children are dying from opioids prescribed for pain relief and those designed to help people addicted to opioids recover, like methadone, a popular medication-assisted treatment (MAT).
  • "An opioid is an opioid, whether if it's to treat an addiction or not, children are at risk of poisoning," Gaither says.
  • One problem, Gaither notes, is that some MATs and prescribed opioids are not child-proofed. "One of them looks like brightly colored strips of paper, like Listerine strips, that are attractive to children," she says.

Details:

  • Out of the total 8,986 deaths, 73% (6,561) are linked to prescription opioids.
  • 81% of the deaths were unintentional.
  • Teens 15–19 had the highest death rate, mostly linked to heroin, which alone showed a 405% growth over that period.
  • Deaths in children aged 10–14 accounted for 4% and those ages 5–9 were 1%.
  • Children younger than 5 experienced almost 7% of the deaths — about 25% of which were from deliberate homicide, Gaither says. This finding needs further research, she adds.
  • 38% died at home — a finding that Gaither says "surprised" her.
  • Non-Hispanic white males experienced the highest mortality but in recent years non-Hispanic black children accounted for a larger proportion.

The big picture: "The epidemic is evolving in ways that we haven't been able to keep up with," Gaither says. Children's deaths track the overall epidemic waves, she says, with a spike from prescriptions in the late 1990s, showing a decline in 2008 as physicians became more careful in prescribing. But this was followed by increased usage and deaths from heroin and synthetic opioids, Gaither says.

What's next: Lawmakers, public health officials, clinicians and parents must implement protective measures to address the growing epidemic, Gaither says — such as efforts to make opioids and MATs more child-proof, and consideration of the family context when physicians write prescriptions.

Go deeper:

Go deeper

Updated 28 mins ago - World

Hong Kong media tycoon Jimmy Lai arrested under national security law

Media tycoon Jimmy Lai at the Next Digital offices in Hong Kong in June. Photo: Anthony Wallace/AFP via Getty Images

Hong Kong pro-democracy activist Jimmy Lai has been arrested for "collusion with foreign powers" and the offices of his newspaper raided, said Mark Simon, an executive at the tycoon's media firm Next Digital on Monday.

Why it matters: He was arrested under the new national security law that gives Beijing more powers over the former British colony. Lai is the most prominent person arrested under the law — which prompted the U.S. to sanction Chinese officials, including Hong Kong leader Carrie Lam, over Beijing's efforts to strip the territory of its autonomy.

Updated 38 mins ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Global: Total confirmed cases as of 1:30 a.m. ET: 19,861,683 — Total deaths: 731,326 — Total recoveries — 12,115,825Map.
  2. U.S.: Total confirmed cases as of 1:30 a.m. ET: 5,044,864 — Total deaths: 162,938 — Total recoveries: 1,656,864 — Total tests: 61,792,571Map.
  3. Politics: Pelosi says states don't have the funds to comply with Trump's executive order on unemployment — Mnuchin says Trump executive orders were cleared by Justice Department.
  4. States: New York reports lowest rate of positive coronavirus test results since pandemic began
  5. Public health: Ex-FDA head: U.S. will "definitely" see 200,000 to 300,000 virus deaths by end of 2020. 
  6. Schools: 97,000 children test positive for coronavirus in two weeks — Nine test positive at Georgia school where photo showing packed hallway went viral .

97,000 children test positive for coronavirus in two weeks

A boy has his temperature checked as he receives a free COVID-19 test in South Los Angeles in July. Photo: Mario Tama/Getty Images

At least 97,000 children tested positive for COVID-19 in the final two weeks of July and there's been an estimated 338,000 cases involving kids in the U.S. since the pandemic began, a new report finds.

Why it matters: The findings in the report by the American Academy of Pediatrics and the Children’s Hospital Association comes as schools and day cares look to reopen in the U.S., with New York Gov. Andrew Cuomo (D) announcing Friday that school districts in the state can reopen in the fall amid lower coronavirus transmission rates.