BACKGROUND Our objective was to describe trends and deaths in young children associated with opioid analgesics. METHODS Analysis of pediatric exposures using the RADARS System Poison Center Program from July 1, 2010 through December 31, 2018. Cases involving a child < 6 years, with an exposure to one or more opioids: buprenorphine, fentanyl, hydrocodone, hydromorphone, methadone, morphine, oxycodone, oxymorphone, and tramadol. Poisson regression was used to model the shape of the time response curve. RESULTS 48,560 cases were identified, median age 2 years (IQR 1.4, 2.0), 52.4 % male. The most commonly involved opioid was hydrocodone (32.5 %); buprenorphine and methadone had the highest exposure rates when adjusted for dispensed prescriptions (0.84 and 0.73 per 10,000 prescriptions). There were 28 deaths, methadone being the most commonly involved opioid (16). Exposures decreased significantly accounting for population (from 8.39 to 4.19 exposures per 100,000 children) and per prescription (from 0.33 to 0.25 exposures per 10,000 prescriptions). After adjustment for prescriptions, the exposure rate for hydromorphone and fentanyl increased over the study period, while buprenorphine had the greatest decrease in exposure rate. Among 28 deaths, 11 (39 %) were known or suspected to have been exposed, but medical care was not sought or was delayed. CONCLUSION Pediatric opioid exposure rates by prescription and population decreased from July 2010 through December 2018. However, with over 48,000 exposures and 28 deaths, the opioid epidemic continues to impact young children. Many exposures including deaths were preventable. Continued improvements in prevention require a multifaceted approach.

中文翻译：

---

处方阿片类药物流行对幼儿的影响：趋势和死亡率。

背景技术我们的目的是描述与阿片类镇痛药有关的幼儿的趋势和死亡。方法从2010年7月1日至2018年12月31日，使用RADARS系统毒物中心计划对小儿暴露进行分析。涉及6岁以下且接触一种或多种阿片类药物的儿童：丁丙诺啡，芬太尼，氢可酮，氢吗啡酮，美沙酮，吗啡，羟考酮，羟吗啡酮和曲马多。使用泊松回归对时间响应曲线的形状进行建模。结果确定了48,560例病例，中位年龄2岁（IQR 1.4，2.0），男性占52.4％。最常见的阿片类药物为氢可酮（32.5％）。调整配药处方后，丁丙诺啡和美沙酮的暴露率最高（每10,000份处方0.84和0.73）。有28人死亡 美沙酮是最常见的阿片类药物（16）。受人口影响（每100,000名儿童从8.39减少到4.19）和每张处方（每10,000处方从0.33减少到0.25），暴露量显着下降。调整处方后，氢吗啡酮和芬太尼的暴露率在研究期间有所增加，而丁丙诺啡的暴露率下降最大。在28例死亡中，有11例（39％）已知或怀疑已经暴露，但并未寻求医疗或延迟了医疗。结论从2010年7月到2018年12月，按处方和人口计算的小儿阿片类药物接触率有所下降。然而，阿片类药物的流行继续影响着幼儿，其暴露量超过48,000次，死亡28人。包括死亡在内的许多接触都是可以预防的。