Are community level prescription opioid overdoses associated with child harm? A spatial analysis of California zip codes, 2001–2011

Abstract

Background Non-medical prescription opioid use is increasing globally within high-income countries, particularly the United States. However, little is known about whether it is associated with negative outcomes for children. In this study, we use prescription opioid overdose as a proxy measure for non-medical prescription opioid use and ask the following: Do California communities with greater rates of non-medical prescription opioid use also have higher rates of child maltreatment and unintentional child injury? Methods We used longitudinal population data to examine ecological associations between hospital discharges involving overdose of prescription opioids and those for child maltreatment or child injury in California zip codes between 2001–2011 (n = 18,517 zip-code year units) using Bayesian space-time misalignment models. Results The percentage of hospital discharges involving prescription opioid overdose was positively associated with the number of hospital discharges for child maltreatment (relative rate=1.089, 95% credible interval (1.004, 1.165)) and child injury (relative rate= 1.055, 95% credible interval (1.012, 1.096)) over the ten-year period, controlling for other substance use and environmental factors. Conclusions Increases in community level prescription opioid overdoses between 2001–2011 are associated with a 2.06% increase in child maltreatment discharges and a 1.27% increase in discharges for child injury. Communities with higher rates of non-medical prescription opioid use may experience greater levels of child harms.

What about the children? How opioid use affects child well‐being

“…First, Quast et al (2018) and Wolf et al (2016) use data from only one state (Florida and California). Ghertner et al (2018) exclude counties with fewer than 10 child welfare cases.…”

“…But there has been a documented increase in illegal substance use, which would not be captured in legal prescription data. Therefore, as in Ghertner et al (2018) and Wolf et al (2016), we also measure inappropriate opioid use by using opioid‐related visits to the ED. We also build upon Ghertner et al (2018)–who use drug overdose deaths—by studying fatalities involving opioids specifically (i.e., not including alcohol and other substances).…”

“…By linking birth records, hospital discharge data, and Child Protective Services (CPS) records in California, Prindle et al (2018) find that 61% of infants born with prenatal substance exposure were reported to CPS before their first birthday. Wolf et al (2016) find a positive relationship between hospital discharges involving prescription opioid overdoses and hospital discharges for child maltreatment and child injury in California. Using county‐level data from Florida (Quast et al, 2018) and California (Quast et al, 2019), studies have shown positive relationships between legal opioid prescription distribution and child removal from homes, though there is no relationship before 2015 in California (Quast et al, 2019).…”

Effects of Opioid Dependence on Visuospatial Memory and Its Associations With Depression and Anxiety

“…Substance misuse is a chronic condition often characterized by remissions and relapses (1). Individuals with a history of long-term opioid dependence may demonstrate cognitive impairments, primarily within the executive functioning domains (2–8).…”

Propuesta de modelos predictivos en salud mental para la personalización de terapias de rehabilitación en pacientes con adicciones

“…En particular, se han documentado resultados negativos entre los niños y los jóvenes que crecen en familias y comunidades caracterizadas por trastornos por consumo de drogas (Taylor et al, 2003). En dos estudios realizados en los Estados Unidos se constató que las tasas de detenciones relacionadas con las drogas (Freisthler, Needell and Gruenewald, 2005) y las altas hospitalarias relacionadas con sobredosis de opioides estaban asociadas con las tasas de maltrato infantil (Wolf et al, 2016). También se observó que el aumento de las sobredosis causadas por opioides de venta con receta entre 2001 y 2011 en Estados Unidos coincidió con un aumento del 2% en las hospitalizaciones relacionados con el maltrato infantil y un aumento del 1% en las relacionadas con lesiones infantiles (Wolf et al, 2016).…”