By Katie Wendell and BJ Bethel
Dayton Daily News
DAYTON, Ohio — Dayton Children’s Hospital is treating as many as two children a week for opioid overdoses due to accidental exposure since the beginning of 2017.
“It seems like every week we are having the same conversation about kids who have symptoms of opiate exposure,” said Kelly Liker, a pediatric physician at Dayton Children’s. “We’re talking about kids coming into contact, breathing, touching, we really don’t know. We’re calling it an accidental exposure to fentanyl or opiates.”
She began her job here in May and said the situation is like nothing she’s seen.
“It’s clear it’s a much bigger issue here,” she said. “We’ve been called the epicenter of the opioid crisis.”
The death of 13-month-old Mari’Onna Allen of Dayton in May is one of two deaths of children from drug intoxication confirmed so far in Montgomery County in 2017. There was one death of a child from fentanyl intoxication in the county last year.
But doctors and caseworkers with Montgomery County Children’s Services say the issue is even worse when you look at the number of kids being treated for symptoms of possible drug intoxication, even if testing can’t always identify what they were exposed to.
“We’ve had other children on scene, found to be in an OD situation, who responded to Narcan, so it would give impression of opiates,” said Jewell Good, county Children’s Services assistant director.
The Dayton Fire Department didn’t have numbers from past years to compare, but so far this year first responders have treated 22 juveniles for suspected overdoses including two infants and 10 children under the age of six.
Children’s Services has been involved with four cases of children under the age of four so far this year where opioid exposure is speculated based on circumstances, environment and adult practices surrounding the child, Good said.
“But we can’t say that was definitely the case,” she said.
That’s because the blood tests available at the hospital can’t detect all the synthetic analogues of fentanyl that are now the most common culprits in local overdoses.
“Drug screens are resulting negative, which is not a definitive answer,” Good said.
Liker said drug dealers developing new analogue combinations are like hackers. They are getting ahead of the medical community’s ability to develop tests.
“It used to be the most common opiate was heroin,” Liker said. “That’s standard in a drug screen. But fentanyl and analogues are making it difficult to test for.”
The new drugs are also much more powerful and just coming into contact with a dusting on someone’s clothing can result in an overdose.
The hospital is erring on the side of treating an overdose first, because there is no harm in giving Narcan to someone not suffering an overdose, Liker said.
“We have a low threshold of suspicion,” she said.
In 2016, 69 percent of the county’s 349 overdose deaths involved a form of fentanyl, alone or in combination with other drugs. This year, the coroner’s office reports fentanyl was suspected in 99 of the first 100 overdose deaths in the county.
From a child protective services standpoint, a negative drug screening can be problematic, Good said, because it can hinder the agency’s ability to remove a child from their home.
In one recent situation, a child was revived with Narcan, but tested negative for opiates. The agency didn’t have the grounds to remove that child in court.
“It’s a struggle knowing I have to leave this child in this situation,” Good said.
Liker said it is hard to predict what long-term consequences children exposed to opioids could have. Many of the children the hospital is treating for exposure have had other health issues due to their living environment, she said.
Children’s Services is developing new protocols on how to handle these situations involving police, prosecutors, judges and addiction services. Officials there said everyone from administrators to case workers are having to become addiction experts in order to deal with the crisis and how it’s affecting local children.
The opioid epidemic is largely responsible for an 11 percent increase in children in custody in six years statewide, according to information from the Public Children Services Association of Ohio.
Agencies are struggling to find homes for children as multiple members of the same family are increasingly addicted and children are remaining in foster care longer due to the time it takes to recover from opioid addiction, the PCSAO reports.