Rege SV, Ngo DA, Ait-Daoud N, Rizer J, Sharma S, Holstege CP. Ann. Epidemiol. 2020; ePub(ePub): ePub.
Affiliation
Division of Medical Toxicology, Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville; Division of Student Affairs, Department of Student Health, University of Virginia, Charlottesville; Department of Pediatrics, School of Medicine, University of Virginia, Charlottesville.
BACKGROUND: Buprenorphine prescriptions have increased dramatically within the United States, whereas methadone continues to be used widely. We investigated the trends and characteristics of buprenorphine and methadone exposures in the pediatric population.
METHODS: We identified pediatric exposures to buprenorphine and methadone using the National Poison Data System from 2013 to 2016. We descriptively assessed characteristics of the exposures. Trends in exposures were evaluated using generalized linear mixed models.
RESULTS: Pediatric buprenorphine exposures increased from 2013 (1097) to 2016 (1226) while methadone calls decreased (486 to 396). After adjusting for the random effects of the geographical region, the mean number of pediatric buprenorphine exposures (per 100,000 pediatric population) increased from 1.3 to 1.5 (P =.05). Conversely, the mean number of methadone exposures decreased from 0.6 to 0.4 (P =.03). Children aged ≤3 years constituted the highest percentage of both exposures. Unintentional exposures accounted for most of the buprenorphine (86.9%) and methadone (62.4%) exposures. Major clinical effects were demonstrated in 2.3% of buprenorphine exposures and were more frequent with methadone (13%). West Virginia and Maryland demonstrated the highest incidence of buprenorphine and methadone exposures, respectively.
CONCLUSIONS: Pediatric buprenorphine exposures increased but demonstrated less severe effects compared to methadone exposures, which decreased during the study period.