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Exposure to fentanyl was listed as the cause of death for eight of 97 “non-natural” deaths of children in Connecticut under the age of 27 months, according to a new report from the Office of the Child Advocate.
The number of deaths, which occurred between January 2019 and August 2022, is a first for the state.
Dr. Kirsten Bechtel, a professor of pediatrics and of emergency medicine at Yale who co-authored the report, told CT Examiner that while they don’t know for certain how the children were exposed, one theory is that utensils carrying trace amounts of fentanyl were either used to mix a bottle of formula or were left out where a child could reach them.
Bechtel noted that the exposure did not happen through breastfeeding.
The advent of fentanyl as a source of pediatric poisoning in Connecticut mirrors what is happening nationwide. According to a study by Julie Gaither from Yale School of Medicine, which was published in the Journal of the American Medical Association in May, child deaths from fentanyl have increased astronomically across the U.S. In 1999, only one in 20 child deaths from opioid exposure were connected to fentanyl. In 2021, that number skyrocketed to 94 percent.
In Connecticut, adult deaths from fentanyl exposure have also increased significantly. In 2015, 26 percent of drug overdose deaths involved fentanyl, compared to 85 percent in 2022.
Bechtel told CT Examiner that there needed to be more help for families struggling with opioid use, including programs to make sure their children aren’t left unsupported in the event of a relapse. Having Naloxone, an opioid antidote, more readily available to families and improving access to treatment for substance abuse, she said, are also critical.
“We have to have a better safety net for these families who have children in terms of how they can reduce their child’s exposure to opioids that they’re using illicitly,” said Bechtel.
She said that includes financial support. The report notes that although four in five children who died from “non-natural causes” were on Medicaid, only half of them were receiving nutritional benefits through the WIC program.
“They’re relatively poor, and … reducing the stresses that cause one to relapse with opioid use disorder — and that might be financial, that might be childcare, that might be family support, that might be home visiting — all those things might be helpful to families whose caregivers struggle with opioid use disorder,” she said.
Seven of the eight children who died of fentanyl exposure in Connecticut were children of color, which Bechtel said also mirrored national findings. She suggested that this may be connected to poverty rates and opportunities available to these families.
“If you can make it out of the first year of life in Connecticut, you’re pretty good,” said Bechtel. “So we really have to concentrate on the first year of life.”
The report also noted that between June 2021 and May 2023, the state Department of Children and Families documented over 20 critical incident reports of “suspected ingestion of opioids and concerns of abuse/neglect by a caregiver” in children under three.
According to an October 22 memorandum from DCF Deputy Commissioner of Operations Michael Williams, the department began creating short-term interventions in response to an increase in fentanyl-related deaths in children. The memorandum requires child protection workers, clinicians and an attorney to meet together and decide the best course of action, which could include removing the person using fentanyl from the child’s home, or adding unannounced visits.
“As fentanyl use became a national public health crisis, DCF assembled a multidisciplinary group of senior leaders, and consulted with local and national experts including our partners at DMHAS, to revise our substance use disorder policy … for cases with fentanyl concerns, we developed guidelines on short- & long-term interventions which received national attention and resulted in more qualitative assessment for the children and families we serve,” DCF Commissioner Vanessa Dorantes said in a statement.