Professionals need to pay more attention to the potentially fatal risk of children ingesting opiate substitutes prescribed to parents, Adfam has warned.
A report by the substance misuse charity says that between 2003 and 2013 there were 20 serious case reviews that involved children taking medicines like methadone and buprenorphine that had been prescribed to help treat parents who were using heroin or other opiates.
These serious case reviews involved 23 children ingesting opioid substitution treatment (OST) medicines, including 17 who died as a result.
In 5 of the serious case reviews, parents had deliberately given methadone to their children to pacify them and in several more cases this was suspected.
The charity said that professionals working with these families were not considering the risks OST medicines posed to children in the care of drug addicts and found inconsistencies in the attention paid to safeguarding concerns by pharmacists.
This is despite NICE guidelines stating that practitioners should consider the lifestyle and family situation of those they intend to give OST medicines.
“Just one of these cases would be one case too many, but this research shows that they have happened with depressing regularity over the last decade,” said Adfam chief executive Vivienne Evans.
“Safeguarding should be first and foremost in professionals’ minds when working with parents who use drugs and alcohol, and the report suggests this isn’t always the case.
“We need a more proactive and nationally coordinated plan to tackle these risks, rather than waiting for every area in teh country to experience a tragedy before anyone takes action.”
The charity’s report says that opiate substitutes remain a important treatment method but calls for drug services, GPs and pharmacists to be given more training on the potential risk to children.
It also urges the government to start collecting data on the number of under 18s who enter hospital after ingesting these drugs and to record the number of children and young people who die from ingesting these medicines.
The government should also do more to ensure NICE’s guidelines on protecting children when making decisions about adult prescriptions are followed, says the report.
The charity’s report says that in 2011/12 there were 60,596 parents in England who were being treated with OST medicines.
The findings were welcomed by Labour MP Meg Munn.
“This important report shows that not enough is being done to protect children from methadone being taken by adults,” she said.
“If more children are not to die then the government must ensure significant improvement in the practice and procedures of organisations working with drug users.”
A spokesperson for drug treatment charity CRI added: “While OST is an integral part of the recovery process for many people, these are powerful drugs that can be fatal if taken outside of prescribing guidelines.
“That’s why it is essential that we have robust prescribing processes in place, and that we educate OST users on the dangers to children of not properly storing these medicines.”
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When chair of Bristol’s LSCB in 2011 I wrote to the secretaries of state for health and for education alerting them to concerns that young children were being given or were accessing opiate substitutes and were dying. We are now 3 years on and young children are still dying. In Bristol there is now 7 day-a-week pharmacist supervision of the taking of opiate substitutes. This ought to be a national requirement and the Department for Health should introduce it as a national policy. It is not rocket science, but it does have a relatively small commissioning cost for the NHS. In the absence of central government action each LSCB should seek to have the issue addressed within their local area.