The National Opioid Epidemic and the Risk of Outpatient Opioids in Children

How should we approach parental refusals of opioids on behalf of children in the perioperative setting? A practical approach based on ethical theory

“…15 In one study, over 40% of 12th graders and nearly 20% of 8th graders believed that is was either "fairly easy" or "very easy" to access prescription opioids. 16 Although the exact contribution of prescription opioids to opioid-related deaths has been challenged, 17,18 caution is clearly warranted when using opioids in the pediatric population.…”

The opioid crisis should lead pediatric anesthesiologists to a broader vision of opioid stewardship

“…In balancing the conflicting desires to practice responsibly in the face of concerns about an opioid crisis, but not under‐treat the children who need pain relief currently best provided by opioid medications, the ethics literature on stewardship may provide some guidance. The duty of stewardship applies to the space between the obligations of healthcare providers to provide beneficent care to their individual patients on the one hand and their obligations to bring about and support a just and safe healthcare system for their patients and society as a whole .…”

“…Recent pediatric anesthesia discussions caution against a reactionary response to the opioid crisis . Missing from these discussions, however, is consideration of the growing body of scholarship and journalism depicting the magnitude of industry influence on physician opioid prescribing practices.…”

US opioid prescribing: the federal government advisers with recent ties to big pharma

“…In November 2018 NASEM convened the first meeting of its new panel, declaring all panelists free of financial conflicts. But three months earlier Pediatrics had published a commentary about the “national opioid epidemic” by panelist Steven Weisman, medical director of pain management at the Children’s Hospital of Wisconsin, in which he disclosed having “conducted trials involving opioid medication in children for [drug maker] the Medicines Company” and receiving “honoraria for lecturing on pain and analgesia.”14…”