A new study from Western researchers in collaboration with the Office of the Chief Coroner of Ontario highlights the scope of opioid-related deaths in young children in Ontario, while providing a clearer picture of the risk factors.
The province-wide study published in the journal Paediatrics & Child Health, looked at specific cases of opioid-related deaths in children under 10 and used situational descriptions to help identify areas for potential interventions. The researchers found that from 2017 to 2021 in Ontario, 10 children died from opioid overdose - the oldest just four years old and the youngest nine months old. This is the first study to analyze opioid-related deaths in those under 10 in Canada and examine the circumstances to help prevent these tragic outcomes in the future.
Dr. Michael Rieder
"The coroner's office identified a series of deaths of children with opioids, but there was a gap in understanding related to the circumstances or the risk factors surrounding the deaths," said Dr. Michael Rieder, lead author and Schulich School of Medicine & Dentistry professor.
The Office of the Chief Coroner of Ontario is the largest centralized coroner system in North America. It collects data from across the province, including data containing detailed information regarding opioid-related deaths through an Opioid Investigative Aid database.
Opioids are a group of drugs that includes fentanyl, usually prescribed to relieve pain. However, high doses can slow breathing and heart rate resulting in death.
The study found fentanyl to be the primary substance in 80 per cent of the deaths. For most of the cases, the substances were found in the child's play or sleeping area.
"We also looked at the number of deaths in the four years prior to our study period. There were four deaths between 2012 and 2016," said Rieder, professor in the departments of paediatrics, physiology and pharmacology and medicine. "So, the number of deaths has more than doubled."
The researchers note U.S. studies show a similar sharp rise in opioid-related deaths among children.
"There needs to be awareness on the part of physicians and health-care practitioners who care for patients who are using substances, that if there are babies or children in the house, there needs to be an informative, non-judgmental conversation about where drugs are stored and the overall risks," said Rieder.
All of the children who died had previous child welfare service involvement, and seven of 10 children came from households with previous police involvement.
"It was surprising that in essentially every case, a child welfare service had been involved and yet these deaths still occurred," said Rieder.
Preventing opioid-related deaths among children
Increasing education and access to naloxone - a medication that temporarily reverses the effects of opioid overdoses to prevent brain injury and death - is one possible intervention, researchers suggested. They also say more accurate statistics will help optimize targeted interventions.
Rieder also said home visits from child welfare service should include education on safe and secure storage of drugs if drug-associated materials are present in a household, as well as education on safe sleep practices.
