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Medications in Drug Treatment: Tackling the risks to children - one year on

This ‘One Year On’ report expands upon the findings and recommendations of Adfam’s Medications in Drug Treatment: Tackling the risks to children, published in 2014, and further contributes to the debate on reducing the risks to children posed by prescribed medications used in opioid substitution therapy (OST).

Key findings:

  • At least 110 persons aged 18 and under died from ingesting OST medications between 2003 and 2013: 73 in England and Wales, and 37 in Scotland
  • 107 of these were related to methadone, and three to buprenorphine
  • Of the 73 deaths in England and Wales, only seven resulted in a serious case review; meaning that an additional 66 deaths did not
  • Hospitalisation statistics show that between 2003 and 2014, at least 328 children were hospitalised in England due to methadone poisoning
  • These data reveal that the majority of ingestions occur in adolescents, which is contrary to the bias towards younger children evident in serious case reviews
  • Since the original report’s publication, there have been three new serious case reviews (one awaiting publication) involving child ingestions of methadone; all of which involved children aged two and under, with the methadone prescribed to the mother
  • Evidence suggests that methadone is related to a higher mortality risk than buprenorphine
  • A range of approaches are being taken by different local authorities to tackle the issue; yet, the continuation of SCRs where children have come to harm or died after ingesting OST medications means more needs to be done to effectively minimise and manage the risks to children posed by these medications.