Children, Young Adults Frequently Exposed To Unsafe Opioid Prescriptions

Sixty one percent of opioid prescriptions to children and young adults were from dentists or surgeons, reveals a new study.

Opioids are often used as medicines for management of acute pain, such as pain you experience after surgery and toothache. They contain chemicals that relax the body and can relieve pain. But misuse of opioids can lead to opioid dependence and even death. Concerningly, a new study has revealed that children and young adults are frequently exposed to unsafe opioid prescriptions, increasing their risk of overdose, misuse, and addiction.

Mostly, dentists and surgeons prescribe opioids to children and young adults who have pain from surgery, dental care and other conditions. But half of these prescriptions pose high risk because of their potential for adverse outcomes, said the study published in Pediatrics.

Lead author of the study is Kao-Ping Chua, a pediatrician and researcher at University of Michigan Health C.S. Mott Children’s Hospital and the Susan B. Meister Child Health Evaluation and Research Center.

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Most common types of high-risk opioid prescriptions

For the study, researchers at the University of Michigan analyzed roughly four million opioid prescriptions dispensed to kids and young adults under age 21 in 2019. High-risk prescriptions were identified as those prescriptions that exceeded a recommended supply or dose or included a drug or combination of drugs not recommended for children.

They found that the most common types of high-risk opioid prescriptions were those for acute pain and that were prescribed beyond three or seven days. Mostly these prescriptions were related to dental and surgical procedures that don’t require long durations of opioid therapy, the authors added.

Take note: The US Centers for Disease Control and Prevention (CDC) states that a three-day supply is usually enough for acute pain and prescriptions exceeding seven days are rarely necessary.

Common opioid prescriptions dispensed to young children aged 0 to 11 included codeine or tramadol. The authors noted that the U.S. Food and Drug Administration has explicitly warned against using these drugs in young children following reports of fatal overdose.

Nearly 12 per cent of opioids prescribed to adolescents and young adults aged 12 to 21 years were also considered high risk because they exceeded recommended daily dosages of opioids. Another nearly 5 per cent opioid prescriptions overlapped with benzodiazepines, which are depressants frequently prescribed for anxiety, stress attacks and sleep disorders. Chua’s previous study had found that this overlap significantly increases overdose risk in adolescents and young adults.

According to the new study, 61 per cent of opioid prescriptions to children and young adults were from dentists or surgeons. Opioids are commonly overprescribed to young people after dental and surgical procedures, it said.

How to minimize opioid prescriptions

As these prescriptions were so heavily concentrated among a small group of prescribers, usually dentists and surgeons, the researchers suggested that quality improvement efforts should target these prescribers. Sixty one percent of opioid prescriptions to children and young adults were from dentists or surgeons.

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Lead author Chua mentioned that there have been successful efforts to reduce opioid quantities for adult surgery patients through evidence-based prescribing guidelines, and similar efforts have begun in some pediatric institutions. But he said these efforts should be more widespread.

To reduce codeine and tramadol prescriptions to young children, he suggested that electronic health record systems and pharmacists could prompt clinicians to consider alternatives when they attempt to prescribe these medications. In addition, insurers could also play role by refusing to cover such prescriptions for young children, he said.

In Chua’s previous studies, it was found that almost 80% of dental opioid prescriptions for adolescents and young adults are for tooth extraction and six in 10 privately insured children undergoing tonsillectomy are prescribed opioids. According to him, ibuprofen provides equal pain relief for such procedures.

In conclusion, Chua stated that avoiding unnecessary opioid prescriptions can not only decrease the risk of misuse and overdose but also lower the risk of side effects, such as vomiting and constipation, as well as improve patient experience without compromising pain control.

This post first appeared on The Health Site

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