Epidemiology of pediatric buprenorphine and methadone exposures reported to the poison centers.
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.
['Rege|Saumitra V|SV|', 'Ngo|Duc Anh|DA|', 'Ait-Daoud|Nassima|N|', 'Rizer|Justin|J|', 'Sharma|Sana|S|', 'Holstege|Christopher P|CP|']
D002047:Buprenorphine D002648:Child D002675:Child, Preschool D016208:Databases, Factual D004781:Environmental Exposure D005260:Female D006801:Humans D007223:Infant D008297:Male D008691:Methadone D009292:Narcotic Antagonists D011039:Poison Control Centers D011041:Poisoning D014481:United States
Pediatrics Buprenorphine Methadone NPDS Toxic exposures