By Emma Yasinski
A July study in Pediatrics, “Outpatient Opioid Prescriptions for Children and Opioid-Related Adverse Events,” suggests that children without serious, chronic conditions such as cancer, are getting a surprisingly high number of opioid prescriptions – and that the largest proportion may be coming from their dentists.
The American Dental Association shares the concern, and earlier this year announced a policy to limit opioid prescriptions to seven days or fewer, and to require dentists to take continuing education classes about narcotics.
"Since children constitute a quarter of the U.S. population, we wanted to find out the extent to which the trend of increased opioid prescribing and toxicity has affected children,” lead author Cecilia P. Chung, MD, MPH, Assistant Professor of Medicine at Vanderbilt University School of Medicine, told Incisor.
Dr. Chung and her team studied Medicaid data from 1999-2014 on children ages 2-17 in Tennessee. They estimated the prevalence of opioid prescriptions in the population, tracking which type of provider prescribed them, the dose, and whether or not the patient experienced adverse events.
“We were looking at two issues: first, we wanted to estimate how frequently children without any severe conditions were prescribed opioids. Second, we wanted to find out how many of these children who received an opioid prescription died, went to the emergency room, or were admitted to the hospital due to an opioid-attributed side effect,” Dr. Chung explained.
The team found 1,362,503 outpatient opioid prescriptions. That suggests that on average, roughly 15% of children in Tennessee received an opioid prescription each year.
More than 30% of those adverse-impact prescriptions came from dentists.
Out of every 100,000 prescriptions from any health care provider, 38.3 led to an adverse event such as an emergency department visit, hospitalization, or even death.
“Readers have been surprised by our finding that opioid prescriptions are quite frequent among children,” said Dr. Chung. “Healthcare providers should be aware of the high frequency of opioid prescriptions for children with self-limited conditions, and they should consider opioid alternatives for treating these conditions.”
The data didn’t include each individual patients’ weight, but the team estimated using age, height and weight graphs. They used this information to see if the dosage made a difference in the likelihood of a child experiencing an adverse event related to their opioid prescription.
It did. A higher dose, based on the researcher’s estimates, increased the frequency with which the children experienced these events.
Dr. Chung wouldn’t say when it is appropriate to prescribe opioids to children, deferring that decision to individual providers, but emphasized that “limiting the doses prescribed to kids can help protect them, because children receiving higher doses of opioids had a higher risk of an adverse event.”
Author: Contributing writer Emma Yasinski received her Master of Science (MS) in science and medical journalism from Boston University. Her articles have also appeared at TheAtlantic.com, Kaiser Health News, NPR Shots, and Genetic Engineering and Biotechnology News.
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