Fentanyl Exposure and Treatment:
What Pediatricians Need to Know

Since 2020, Texas has experienced a 120% increase in fentanyl-related deaths

Texas Department of State Health Services (2023)

Choose any section below to learn more.

Fentanyl:
An Increasing Danger

Recognizing and Reducing Risk Factors

A Texas Health Steps Provider’s Role: Screening and Referral

Medication-Assisted Treatment and Harm Reduction

Opioid Use During Labor, Delivery and Pediatric Procedures

Resources

• Educational Materials

  Texas Health and Human Services (2023). Fighting Fentanyl website features information and resources for youth, young adults, schools and health care workers.

  Texas Workforce Commission (2023). One Pill Kills resources, including flyers, posters, Fentanyl facts and other data points.

  TOGETHER Texans can fight the fentanyl crisis flyer.

• Provider Resources

  DEA One Pill Can Kill.

  Heroes Helpline. (or call 833-367-4689)
  A free, confidential, telephone support line available to EMS and health-care workers.

  Houston Emergency Opioid Engagement System (HEROES).
  Provides clinical and behavioral services in the Houston area for individuals seeking long-term recovery from opioid use disorder.

  National Harm Reduction Coalition.

  Screening tools

  • S2BI (Screening to Brief Intervention).
  • BSTAD (Brief Screener for Tobacco, Alcohol, and other Drugs).
  • HEEADSSS 3.0.
  • CRAFFT (Car, Relax, Alone, Forget, Family or Friends, Trouble) Interview.
  • Opioid Risk Tool – OUD (ORT-OUD).

  Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment National Helpline. Buphrenorphine resources: infoburprenorphine@samhsa.hhs.gov or 866-BUP-CSAT.

  Substance Abuse and Mental Health Services Administration. (2023). Buprenorphine Quick Start Guide.

  Texas Health Steps Anticipatory Guidance Provider Guide.

  Texas Targeted Opioid Response.

  Texas Targeted Opioid Response. Naloxone Standing Order Request.

• References Featured in the Course

  American Academy of Pediatrics. (2022). Joint Principles: Addressing the Opioid Epidemic.

  AAP Training to Treat Opioid Use Disorder in Adolescents. (2023).

  Centers for Disease Control and Prevention. (2021). High School Youth Risk Behavior Surveillance System Survey.

  Committee on Substance Use and Prevention. (2016). Medication-Assisted Treatment of Adolescents With Opioid Use Disorders. Pediatrics, 138(3), e20161893.

  Department of Justice/Drug Enforcement Administration Drug Fact Sheet: Fentanyl. (2022).

  Dotinga, R. Opioids Most Common Contributor to Fatal Poisonings in Young Kids. (2022). MedPage Today, October 12, 2022.
  Drugs and Lactation Database (LactMed). (2023). Fentanyl. Bethesda (MD): National Institute of Child Health and Human Development; 2006-. [Updated 2023 Feb 15].

  Gaw, C.E, Curry, A.E., Osterhoudt. K.C., Wood, J.N., Corwin, D.J. (2023). Characteristics of Fatal Poisonings Among Infants and Young Children in the United States. Pediatrics. e2022059016. 10.1542/peds.2022-059016

  Gonzalez, Lucien, M.D., M.S., FAAP, and Camenga, Deepa R., M.D., M.H.S., FAA. (2022). Fentanyl a rising threat to child health: What pediatricians should know. AAP News, November 16, 2022.

  Kelley-Quon, L. I., Kirkpatrick, M. G., Ricca, R. L., Baird, R., Harbaugh, C. M., Brady, A., Garrett, P., Wills, H., Argo, J., Diefenbach, K. A., Henry, M. C. W., Sola, J. E., Mahdi, E. M., Goldin, A. B., St Peter, S. D., Downard, C. D., Azarow, K. S., Shields, T., & Kim, E. (2021). Guidelines for Opioid Prescribing in Children and Adolescents After Surgery: An Expert Panel Opinion. JAMA surgery, 156(1), 76–90.

  National Council for Mental Wellbeing. (2021). Early Intervention, SBIRT and Harm Reduction.

  National Harm Reduction Coalition. (2023). Principles of Harm Reduction.

  Substance Abuse and Mental Health Services Administration. (2023). Buprenorphine.

  Substance Abuse and Mental Health Services Administration. (2023). Medications for Substance Use Disorders.

  Substance Abuse and Mental Health Administration. (2023). Removal of DATA Waiver (X-Waiver) Requirement. Jan 25, 2023.

  Substance Abuse and Mental Health Services Administration. (2020). Key substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health (HHS Publication No. PEP20-07-01-001, NSDUH Series H-55). Rockville, MD: Center for Behavioral Health Statistics and Quality, Substance Abuse and Mental Health Services Administration.

  Tanz LJ, Dinwiddie AT, Mattson CL, O’Donnell J, Davis NL. (2022). Drug Overdose Deaths Among Persons Aged 10–19 Years — United States, July 2019–December 2021. MMWR Morb Mortal Wkly Rep 2022;71:1576–1582.

  Texas Health and Human Services. (2023). Fighting Fentanyl.

  Texas Health and Human Services. (2023). Naloxone Standing Order Request. Texas Opioid Training Initiative.

  Texas Health and Human Services. (2023). Saving Lives in Texas: The Facts on Fentanyl.

  Texas Workforce Commission. (2023). One Pill Kills.

  United States Congress. (2023). U.S. Congress Consolidated Appropriations Act, H.R. 2617, sect. 1262.

  United States Drug Enforcement Administration. Fentanyl Awareness. (2023).

  United States Drug Enforcement Administration. Get Smart About Drugs flyer for parents. (2022).