Study Warns Teens May Also Be at Risk in Opioid Epidemic

Friends study together while having sandwiches at diner.The rate of opioid addiction and overdose has steadily climbed since 2000. More than 600,000 people died of overdoses between 2000 and 2016. According to the Centers for Disease Control and Prevention (CDC), the majority (66%) of drug overdoses involve opioids. Forty percent of opioid overdoses involve a prescription opioid.

Most research on opioid overdose deaths has focused on adults. Yet according to a study in the Journal of Pediatric Orthopaedics, children and teens are also at significant risk. Doctors often prescribe opioids to youth without following evidence-based guidelines. This can lead to opioid abuse among adolescents.

“The magnitude…of prescription opioid use by children and teenagers is overwhelming,” says Ellan Raney, one of the study’s authors.

The Scope of Childhood Opioid Abuse

The study includes a review of previous literature. The data shows opioid prescription rates began to increase in the 1980s and 1990s. Doctors at the time were concerned about pain management and saw opioids as a solution. The authors of the study believe it was this approach that sowed the seeds of the current opioid epidemic. As many as 16% of Americans now have an opioid addiction.

The study also includes data from an electronic survey of 264 Pediatric Orthopaedic Society of North America (POSNA) members. The survey asked respondents what prescriptions they would offer in seven treatment scenarios. Three-quarters of respondents made pain management decisions without consulting a pain specialist. Physicians often chose medications based on anecdotal experience rather than evidence-based guidelines.

The study found many opioid users do not use all their medication. About a quarter of patients take none of their prescribed opioids following an operation. The rest take one to two-thirds of the prescribed dose. When there are drugs left over, people may be tempted to use them for nonmedical reasons.

This pattern seems to be common among youth. In one report, nearly 13% of high school seniors said they have used opioids for nonmedical purposes. Of the teens who abused opioids, 80% had received a medical prescription. They used the surplus medicine for recreation. Some middle schoolers also abused prescription opioids. An estimated 5% of seventh and eighth graders used opioids recreationally.

The Need for Better Prescribing Standards

The CDC has published guidelines to reduce opioid misuse and overdoses. According to the guidelines, doctors should:

  • Consider other treatment strategies first
  • Only prescribe opioids when medically necessary
  • Start with the lowest effective dose
  • Monitor their patients’ use of opioids.

The study authors suggest similar guidelines may be necessary for doctors treating teens. They say the patients’ distress should be weighed against the risks of addiction and overdose. Doctors may benefit from planning with their patients on how to dispose unused opioids.

Youth who experience opioid addiction may benefit from psychotherapy. A counselor can teach kids strategies for coping with pain and connect parents to relevant resources.

References:

  1. CDC guideline for prescribing opioids for chronic pain. (2017, August 29). Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/drugoverdose/prescribing/guideline.html
  2. Drug overdose deaths in the United States continue to increase in 2016. (2017, August 30). Centers for Disease Control. Retrieved from https://www.cdc.gov/drugoverdose/epidemic/index.html
  3. Opioid crisis affects children and teens too—Journal of Pediatric Orthopaedics outlines strategies to reduce opioid prescribing. (2018, February 28). EurekAlert. Retrieved from https://www.eurekalert.org/pub_releases/2018-02/wkh-oca022818.php
  4. Opioid overdose. (2017, October 23). Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/drugoverdose/index.html
  5. Raney, E. M., van Bosse, H. J., Shea, K. G., Abzug, J. M., & Schwend, R. M. (2018, February 27). Current state of the opioid epidemic as it pertains to pediatric orthopaedics from the advocacy committee of the Pediatric Orthopaedic Society of North America. Journal of Pediatric Orthopaedics, 1. Retrieved from https://journals.lww.com/pedorthopaedics/Abstract/publishahead/Current_State_of_the_Opioid_Epidemic_as_it.98929.aspx?PRID=JPO_PR_022818

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