Opioid-prescribing Patterns for Pediatric Patients in the United States

Abstract

The opioid crisis in America affects both adults and children. However, children are often excluded from health care policies and guidelines aimed at curbing the opioid crises. For example, recent guidelines on opioid prescribing authored by the Center for Disease Control and Prevention (CDC), has exclusively focused on adults. Stakeholders such as patients, providers, and public health agencies feel increased pressure to address the opioid crises and thus guidelines intended for adults may inadvertently be generalized to children. Indeed, some health agencies in the United States have advocated for more restrictive opioid prescribing to children as compared to adults. In order to better address the opioid crises we urgently need more evidence to guide decisions. Thus, this topical review aims to provide a brief overview of the opioid crises affecting children, followed by a synopsis of recent research on opioid prescribing patterns and data on the links between legitimate opioid use and risk for problematic opioid use behaviors.

Spinal Cord Stimulation Improves Functional Outcomes in Children With Complex Regional Pain Syndrome: Case Presentation and Review of the Literature

“…It was found to decrease the debilitating nature of pain in our patient, allowing for better toleration of day‐to‐day functioning. The adolescent population is at particularly increased risk for developing opioid dependence, given both their vulnerable age group and the current opioid crisis with disproportionally high opioid prescription in the United States 26–28 . Reportedly, 73% of pediatric chronic pain patients will continue to have chronic pain in adulthood, reflecting potentially life‐long increased pain morbidity and risk for opioid‐related morbidity and mortality 29 .…”

“…The adolescent population is at particularly increased risk for developing opioid dependence, given both their vulnerable age group and the current opioid crisis with disproportionally high opioid prescription in the United States. [26][27][28] Reportedly, 73% of pediatric chronic pain patients will continue to have chronic pain in adulthood, reflecting potentially lifelong increased pain morbidity and risk for opioidrelated morbidity and mortality. 29 In light of the foregoing, we were compelled to take the detrimental effects of opioids into consideration, being both pertinent to our case and other similarly managed cases.…”

Engaging youth in the design of prescription opioid safety education for schools

“…11 Education on proper opioid use and handling is crucial for the adolescent population, because even those who use legitimately prescribed opioids before 12th grade are more likely to report misuse later in life and are at an increased risk of heroin use. 9,12 Furthermore, opioid-related adverse events among adolescents are more common among those who have filled a valid opioid prescription within the past 6 months and often within 3 days of filling the prescription. 13 Adolescents have a unique capability to be adaptive, use complex communication skills, practice nonroutine problemsolving skills or "think outside of the box," and apply systems thinking when learning.…”

To relieve pain or avoid opioid‐related risk? A comparison of parents’ analgesic trade‐off preferences and decision‐making in 2019 versus 2013 in a single U.S. pediatric hospital

“…3,6 The opioid crisis has prompted recent changes in prescribing policies and recommendations in the United States in an attempt to curtail the volume of opioid analgesics available to children, adolescents, and adults. 7,8 Minimizing prescription opioid exposure is likely to be considered a positive trend; however, the full impact of the opioid crisis on children's pain outcomes may be mixed and remains unclear. Since children's pain is largely managed in the home, it is important to understand the potential influence of societal events on parental beliefs and decisions.…”