Kentucky’s youngest citizens are increasingly falling victim to accidental drug overdoses

By Deborah Yetter
Kentucky Lantern

Kentucky’s youngest children continue to be at risk of drug overdoses from accidental ingestion — with the number of fatalities and the strength of the drug, or combination of drugs, increasing.

Eight children died from ingesting drugs and another 47 suffered an overdose in fiscal year 2022 among cases reviewed by the Child Fatality and Near Fatality External Review Panel, which released its annual report Thursday. 

The majority of overdose victims in the report were age 4 or younger.

Among the drugs Kentucky children are ingesting: opiods, fentanyl, drugs used to treat opioid use disorder, and increasingly, cannabis or products containing THC, the main chemical in marijuana.(Getty Images, via Kentucky Lantern)

Five years ago, by contrast, one child died among the 32 overdose cases it reviewed, the panel reported.

And just a fraction of child overdoses in Kentucky are identified in the report since the panel reviews only cases where abuse or neglect is suspected in the death or near-death of a child.

In 2022, 721 children were treated in Kentucky hospital emergency rooms for drug ingestion, with 72 requiring hospitalization, according to emergency department data, the report said.

Dr. Melissa Currie, a forensic pediatrician and founding member of the panel, said such cases are among her greatest concerns.

“I do believe ingestions are a major problem and it’s getting worse rapidly,” said Currie, a professor of medicine with Norton Children’s Hospital and the University of Louisville medical school. “We need to do a better job of educating parents about how dangerous that is.”

Drug use in the home presents the greatest risk, the report said.

“Children living in a home with a caregiver using illicit or other dangerous substances are at a higher risk of accidental ingestion,” the report said. It said children also are at risk of ingesting drugs used to treat opioid use disorder, such as buprenorphine.

Dr. Melissa Currie (Photo from Kentucky Lantern)

Among the drugs children are ingesting: opiods, fentanyl, drugs used to treat opioid use disorder, and increasingly, cannabis or products containing THC, the main chemical in marijuana.

Often such cases involve a combination of drugs.

One example it cited: A 19-month-old who died tested positive for fentanyl and morphine in a home where an adult overdose death had occurred just two months before and where both parents reported using heroin. Two other children in the home tested positive for fentanyl, a powerful, synthetic opioid.

Cannabis products were linked to the deaths of two children who ingested them, the report said.

Currie said the public doesn’t realize the risks even of legal products derived from hemp, such as gummies.

“It can still put kids in the ICU,” she said.

Most deaths or injuries preventable

Created in 2012 to conduct comprehensive reviews of child deaths and serious injuries from abuse or neglect, the independent panel of physicians, judges, lawyers, police, legislators and social service and health professionals meets regularly throughout the year to analyze such cases.

It is charged with producing an annual report to detail its findings to the governor, lawmakers and other officials along with recommendations for improving conditions for children in a state that has long ranked high for its rate of child abuse and neglect.

State Sen. Danny Carroll, R-Paducah, and a member of the panel, said he has not had an opportunity to review the final report but a spokesman said Carroll and the General Assembly generally consider its findings in crafting public policy.

The 2024 report includes cases from July 1, 2021 to June 30, 2022, and examines 202 cases in which 68 children died and 134 suffered life-threatening injuries.

Of the deaths, the majority were from neglect and 10 from physical abuse.

It found that nearly all — 90% — of the deaths and injuries could have been prevented with appropriate precautions, such as safely storing medications or securing firearms.

Areas the panel examined this year included drug overdoses, physical abuse, neglect, firearm deaths including suicide and the role of the Cabinet for Health and Family Services in responding to reports of child abuse and neglect.

Common factors in child deaths and injuries included household financial stress, mental illness, family violence and addiction.

The report charts only a fraction of Kentucky’s child overdose/ingestion cases because the panel is responsible for looking only at cases involving neglect or abuse in the death or near death of a child. In 2022, 721 children were treated in Kentucky hospital emergency rooms for drug ingestion, with 72 requiring hospitalization, according to emergency department data. (Click for larger graphic)

Here are some of the key findings and recommendations:

Overdose and ingestion cases

In light of a rise in such cases over the past five years, the panel recommends better education for all professionals involved in medication assisted treatment for adults with addiction. 

Among child ingestion cases the panel studied, 37% of their caregivers were receiving such treatment including medication for opioid misuse.

That training should stress reminding patients to safely store medication and for health professionals to report when a parent relapses.

It also recommends the Kentucky Board of Medical Licensure provide more continuing education to doctors on opioid ingestion in children.

The report also recommends training for medical marijuana providers. The Kentucky General Assembly in 2023 approved the use of medical marijuana for certain serious conditions though the law does not take effect until 2025.

It also urges more public education on safe-sleep practices and the dangers of a child sleeping with an adult, especially one who is impaired.

“Drinking and drug use (even prescribed) impair our ability to care for a child, making bed-sharing and other unsafe sleep practices even more dangerous,” the report said.

The panel, for the seventh year in a row, asked lawmakers to fund family recovery courts statewide, now offered only in Jefferson and Clay counties.

And it urges a statewide system to create a “Plan of Safe Care,” a federally required system to track and assist families with children at risk, particularly infants born exposed to drugs.

Despite the federal requirement,  Kentucky — and most states — have not fully implemented such a system with responsibility not clearly defined.

“We need to put this on everyone’s radar,” Currie said. “Somebody needs to step in and take responsibility or the legislature needs to assign responsibility.”

Firearms a ‘deadly means’

The report notes access to firearms continues to put children at risk.

In one case, a 4-year-old playing with a loaded handgun he found in the glove compartment of a car fatally shot himself. In another, a 14-year-old was fatally shot in the head by a friend while handling a loaded firearm in the parents’ bedroom.

It also factors in child suicides, the report citing the death by suicide of a 14-year-old boy who had access to unsecured firearms in the home.

The panel reviewed seven suicide cases from 2022, five fatal — four involving a firearm — and two attempts resulting in serious injury. The average age of the child was 13.

Sadly, the panel reports, the cases  it reviewed were just a portion of all suicide deaths of youths in Kentucky for 2022, when . a total of 29 children under 18 died by suicide..

The report cited “a significant increase” in firearm injuries in cases it reviewed for the past five years involving 48 deaths and 24 near fatalities.

The panel classified such cases as “access to deadly means” that were largely preventable. In many cases, parents had told children not to handle firearms or thought they had hidden the weapon, the report said.

“Contrary to the beliefs of many parents, research demonstrates most children know where guns are stored and will touch a firearm if provided the opportunity despite education not to touch the firearm,” it said.

The panel recommends the legislature research national models and develop legislation to promote safe storage of firearms.

Currie said she understands firearms legislation is controversial but said it shouldn’t be when it comes to child safety.

“It should be a non-issue,” she said. “That should be something we can all agree on.”