A tragic incident occurred at a state-licensed day care in the Bronx, resulting in the death of a 1-year-old boy and hospitalization of three other children. City officials have revealed that all four children were exposed to an opioid, and the police discovered drug-dealer packaging at the day care site.
The New York City medical examiner’s office has conducted an autopsy but requires further examination to determine the cause of death for the 1-year-old. Health officials have not disclosed whether the children were tested for drugs.
Although investigations are ongoing, police officials suspect opioid exposure due to the symptoms exhibited by the children and the presence of a “kilo press” at the day care. This incident highlights the danger that opioids, including fentanyl, pose to children.
Do we know whether opioids were responsible?
The police haven’t disclosed much information regarding their investigation or their swift focus on opioid exposure as a likely explanation.
Reports indicate that some of the children affected were revived using Narcan, an overdose-reversal medication. According to Dr. Sharon Levy, an expert in addiction medicine, this suggests that the children were likely exposed to opioids, which include prescription pain relievers, heroin, and fentanyl.
Opioids primarily cause fatalities by binding to receptors responsible for controlling breathing and heart rate. Narcan binds to the same receptors, effectively counteracting the effects of opioids.
If Narcan successfully revived the children in the Bronx, it implies that opioids had indeed affected those receptors, as explained by Dr. Levy.
How can children be exposed?
The exact manner in which the children at the Bronx day care came into contact with opioids remains unclear.
However, a study published in The Journal of Pediatrics in 2019 revealed that nearly all cases of children’s opioid exposure involved ingesting the drug orally.
The study analyzed more than 80,000 records of children under 18 who had been exposed to opioids over a five-year period. Around 99 percent of the exposures occurred through unintentional oral ingestion.
Although rarer cases of exposure involved inhalation or contact with children’s eyes, ears, or rectums, the reported data in the study has limitations, making it difficult to determine if these types of exposure alone could poison children.
Can touching opioids sicken children?
There have been occasional reports of police officers or emergency medical workers falling ill due to accidental absorption of fentanyl through the skin or inhalation of airborne powder, leading to warnings from federal drug officials.
However, a scientific consensus suggests that unintentional opioid exposure through touch is highly unlikely. Opioids are not easily absorbed through the skin and are not typically present in the air.
Researchers studying child opioid overdoses have called for further investigation into the exact mechanisms of these poisonings. Nevertheless, they believe that children are unlikely to become sick by touching opioids or inhaling them accidentally.
According to Dr. Levy, if the children in the Bronx were exposed to opioids, it is highly probable that they orally ingested the drug.
She stated, “I don’t think it’s actually well absorbed enough through the skin to do this kind of thing.” She also stated that airborne poisoning is unlikely.
Dr. Levy adds, “Whether enough could get in from an environmental exposure, I would really doubt it, even in a small child where it’s true that you need much less of a dose.”
Why are children at higher risk of overdoses?
Experts explain that a small child and an adult exposed to the same quantity of opioids would experience significantly different levels of harm due to children’s smaller bodies. This size difference places children at a higher risk of overdosing.
While children may receive opioid treatment after dental or surgical procedures, doctors always take into account the patient’s body weight when determining the appropriate dosage, as is the case with most drugs.
Dr. Levy points out the significant dosage difference for someone weighing 10 or 12 kilos compared to a 70-kilo adult, emphasizing that an adult dose would pose a major problem for a small child.
Additionally, studies suggest that young brains have lower concentrations of a protein that could aid in preventing various chemical compounds from crossing the blood-brain barrier. This lower protein level may contribute to increased toxicity in children exposed to certain opioids.
How common are child overdoses?
A study published in the journal Pediatrics highlights that opioids were the leading cause of poisoning deaths among children aged 5 and younger between 2005 and 2018.
Out of 731 poisoning-related deaths analyzed from 40 states, opioids contributed to 47 percent of those fatalities.
Over the past decade, children have been exposed to new sources of opioids. In addition to the usual prescription opioids, children have also come into contact with heroin and synthetic opiates like fentanyl and buprenorphine.
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