Opioids in Pediatrics: What Could Possibly Go Wrong?

An important step in preventing opioid addiction is to reduce early exposure to the powerful narcotics. Study results announced during an American Academy of Orthopaedic Surgeons (AAOS) virtual meeting found a 52% drop in opioid prescription rates in the pediatric population between 2004 and 2017.

Over the 14-year observational period prescription rates dropped from 60% to 27.8% for children aged 10-18 seeking care for minor fracture or dislocation. The study found higher prescription rates in the South and Midwest regions of the U.S. The largest decline in prescription rate occurred between 2015 and 2016.

In the press release issued by the AAOS, John Flynn, M.D., FAAOS and chief of the Division of Orthopedic Surgery at Children’s Hospital of Philadelphia said, “The statistics on opioid-related misuse are alarming and reducing the use of opioids in pediatric orthopedic patients is essential. As orthopedic surgeons, we have a responsibility to realize that our surgical patients are more likely to die from their pain medicine than from the injury or operation.”

Dr. Flynn was a study author, along with first author Jigar Gandhi, MD. The study, “Getting the Message: The Declining Trend in Opioid Prescribing for Minor Orthopaedic Injuries in Children and Adolescents over the Past 14 Years” retrospectively reviewed the national Pediatric Health Information System, a database contributed to by 42 children’s hospitals. The study cohort consisted of over 120,000 children. Over the entire study period whites, males and adolescents were prescribed opioids more frequently than non-whites, females, and younger children, respectively.

Children make up a sizeable proportion of the opioid abusing population in the U.S. In 2016, over 750,000 children misused opioids according to the “2017 National Survey on Drug Use and Health”. Nearly 9,000 children died between 1999 and 2016 due to opioid abuse according to a study in JAMA Network Open. Opioid use in high school aged children leads to a 33% increase in abuse risk in the future, according to another study in Pediatrics. The study offers a promising trend in opioid prescription behavior.