Opioid Prescribing to Adolescents in the United States From 2005 to 2016

Henke, Rachel Mosher; Tehrani, Ali Bonakdar; Ali, Mir M.; Mutter, Ryan; Mazer‐Amirshahi, Maryann; O’Brien, Peggy L.; Mark, Tami L.

doi:10.1176/appi.ps.201700562

Cited by 8 publications

(10 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In 2016, there was a substantial increase in 1-day opioid prescriptions. 50 These trends mirror the nation's opioid epidemic. In a large retrospective analysis of opioid-naive postoperative patients, Harbaugh et al 51 found that opioid use persisted (prescriptions filled >90 days' postoperation) in 5% of patients (4267 patients), ranging from 2.7% to 15.2% across surgical procedures.…”

Section: Social and Economic Risk Factors To Adolescent Opioid Misusementioning

confidence: 99%

Personal and Socioeconomic Determinants in Medication-assisted Treatment of Opioid Use Disorder in Adolescents and Young Adults

Grubb

2019

Clinical Therapeutics

View full text Add to dashboard Cite

Opioid use disorder (OUD) is a pediatric and adolescent problem as most young adults (aged <25 years) in treatment programs report initiating use before 25 years of age, and there are lifelong impacts from early substance use necessitating early screening for opioid use and subsequent treatment. Medicationassisted treatment (MAT) is a highly effective intervention for OUD, and there is strong evidence for its use with adolescents; however, most adolescents with OUD are unable to access MAT or remain in MAT long term to achieve substantial recovery. Using case examples drawn from a pediatric and adolescent physician's experiences proving MAT to adolescents and young adults (ages 16e24 years), this article explores the personal and socioeconomic determinants in MAT of OUD in adolescents and young adults and provides suggestions for advocacy areas and resources to improve MAT with this population. (Clin Ther. 2019;41:1669e1680)

show abstract

Section: Social and Economic Risk Factors To Adolescent Opioid Misusementioning

confidence: 99%

Personal and Socioeconomic Determinants in Medication-assisted Treatment of Opioid Use Disorder in Adolescents and Young Adults

Grubb

2019

Clinical Therapeutics

View full text Add to dashboard Cite

show abstract

“…[14][15][16][17][18][19]40 Earlier studies of trends in opioid prescribing among adolescents and younger adults have found stable or decreasing opioid prescribing rates within the past several years and decreases in long-duration prescriptions, although, to our knowledge, no studies have examined trends in high-risk opioid prescribing practices. [22][23][24]41 Our findings might reflect changing norms about opioid prescribing, related to policy changes for adults, such as the publication of the Centers for Disease Control and Prevention guideline for prescribing opioids for chronic pain published in 2016, 31 which states that clinicians should prescribe the lowest effective dose and duration of opioids, as well as state legislation limiting duration and amount of opioid prescribed. 25 Opioid prescribing guidelines and efforts focused on deprescribing for adolescents and younger adults at risk for opioid dependence are important strategies to reduce unnecessary prescription opioid use.…”

Section: Discussionmentioning

confidence: 86%

“…[20][21][22][23] One study in adolescents assessed trends in prescription duration, showing a decrease in short-duration prescriptions. 24 However, to our knowledge, no US populationbased studies have provided a comprehensive look at trends in opioid prescribing practices, including amount prescribed, duration, high-dosage, and ER/LA prescriptions, in the pediatric, adolescent, and younger adult populations.…”

mentioning

confidence: 99%

Temporal Trends in Opioid Prescribing Practices in Children, Adolescents, and Younger Adults in the US From 2006 to 2018

et al. 2021

View full text Add to dashboard Cite

IMPORTANCE Prescription opioids are involved in more than half of opioid overdoses among younger persons. Understanding opioid prescribing practices is essential for developing appropriate interventions for this population. OBJECTIVE To examine temporal trends in opioid prescribing practices in children, adolescents, and younger adults in the US from 2006 to 2018. DESIGN, SETTING, AND PARTICIPANTS A population-based, cross-sectional analysis of opioid prescription data was conducted from January 1, 2006, to December 31, 2018. Longitudinal data on retail pharmacy-dispensed opioids for patients younger than 25 years were used in the analysis. Data analysis was performed from December 26, 2019, to July 8, 2020. MAIN OUTCOMES AND MEASURES Opioid dispensing rate, mean amount of opioid dispensed in morphine milligram equivalents (MME) per day (individuals aged 15-24 years) or MME per kilogram per day (age <15 years), duration of prescription (mean, short [Յ3 days], and long [Ն30 days] duration), high-dosage prescriptions, and extended-release or long-acting (ER/LA) formulation prescriptions. Outcomes were calculated for age groups: 0 to 5, 6 to 9, 10 to 14, 15 to 19, and 20 to 24 years. Joinpoint regression was used to examine opioid prescribing trends.RESULTS From 2006 to 2018, the opioid dispensing rate for patients younger than 25 years decreased from 14.28 to 6.45, with an annual decrease of 15.15% (95% CI, −17.26% to −12.99%) from 2013 to 2018. The mean amount of opioids dispensed and rates of short-duration and high-dosage prescriptions decreased for all age groups older than 5 years, with the largest decreases in individuals aged 15 to 24 years. Mean duration per prescription increased initially for all ages, but then decreased for individuals aged 10 years or older. The duration remained longer than 5 days across all ages. The rate of long-duration prescriptions increased for all age groups younger than 15 years and initially increased, but then decreased after 2014 for individuals aged 15 to 24 years. For children aged 0 to 5 years dispensed an opioid, annual increases from 2011 to 2014 were noted for the mean amount of opioids dispensed (annual percent change [APC], 10.58%; 95% CI, 1.77% to 20.16%) and rates of long-duration (APC, 30.42%; 95% CI, 14.13% to 49.03%), high-dosage (APC, 31.27%; 95% CI, 16.81% to 47.53%), and ER/LA formulation (APC, 27.86%; 95% CI, 12.04% to 45.91%) prescriptions, although the mean amount dispensed and rate of high-dosage prescriptions decreased from 2014 to 2018.CONCLUSIONS AND RELEVANCE These findings suggest that opioid dispensing rates decreased for patients younger than 25 years, with decreasing rates of high-dosage and long-duration prescriptions for adolescents and younger adults. However, opioids remain readily dispensed, and possible high-risk prescribing practices appear to be common, especially in younger children.

show abstract

“…42 At least five states have also placed specific restrictions on daily dosages, and specific restrictions on prescribing for minors. 43 Although these prescribing limits were also enacted with other regulatory efforts directed at opioid prescribing, such as prescription monitoring programs (PMPs), and first-responder naloxone training, 44 restricting opioid prescribing appears to be an important facet of a multi-pronged policy approach to reducing prescription opioid-related misuse, dependence and overdose death. A decline in opioid prescribing since 2011 has coincided with a steep decline in opioid analgesic misuse, and a two-year (2012-2013) decline in the rate of prescription opioid overdose deaths.…”

Section: State and Local Responsesmentioning

confidence: 99%

An Effective Intervention: Limiting Opioid Prescribing as a Means of Reducing Opioid Analgesic Misuse, and Overdose Deaths

Fink¹,

Uyttebrouck²,

Larson³

2020

J. Law. Med. Ethics

View full text Add to dashboard Cite

Overdose deaths involving prescription opioids killed more than 17,000 Americans in 2017, marking a five-fold increase since 1999. High prescribing rates of opioid analgesics have been a substantial contributor to prescription opioid misuse, dependence, overdose and heroin use. There was recognition approximately ten years ago that opioid prescribing patterns were contributing to this startling increase in negative opioid-related outcomes, and federal actions, including Medicare reimbursement reform and regulatory actions, were initiated to restrict opioid prescribing. The current manuscript is a description of those actions, the effect of those actions on opioid prescribing and related patient outcomes. We also describe our proposal of methods of expanding these efforts as an important piece to further reduce opioid-related misuse, dependence, and overdose death.

show abstract

Opioid Prescribing to Adolescents in the United States From 2005 to 2016

Cited by 8 publications

References 9 publications

Personal and Socioeconomic Determinants in Medication-assisted Treatment of Opioid Use Disorder in Adolescents and Young Adults

Personal and Socioeconomic Determinants in Medication-assisted Treatment of Opioid Use Disorder in Adolescents and Young Adults

Temporal Trends in Opioid Prescribing Practices in Children, Adolescents, and Younger Adults in the US From 2006 to 2018

An Effective Intervention: Limiting Opioid Prescribing as a Means of Reducing Opioid Analgesic Misuse, and Overdose Deaths

Contact Info

Product

Resources

About