Opioid Use Disorders in Adolescents—Updates in Assessment and Management

Yule, Amy; Lyons, Rachael M.; Wilens, Timothy E.

doi:10.1007/s40124-018-0161-z

Cited by 22 publications

(21 citation statements)

References 56 publications

(51 reference statements)

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“…It is important that providers continue to regulate prescribed opioids. Parents and guardians should also understand the importance of safe storage of prescriptions, thereby keeping the medications out of reach from children [29]. It is imminent to engage youth and families in psychoeducation, harm reduction strategies, services provided in the community to drop extra medications, and if there are concerns for opioid abuse/dependence, providing individuals and families with naloxone spray.…”

Section: Discussionmentioning

confidence: 99%

Recreational Cannabis Use and Risk of Prescription Opioid Overdose: Insights from Pediatric Inpatients

Pankaj

Oraka²,

Caraballo-Rivera

et al. 2020

Cureus

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Our first goal is to evaluate the prevalence of hospital admissions for prescription opioid overdose (POD) in pediatric inpatients, and next goal is to measure the independent association between cannabis use disorders (CUD) and POD. Methods We used the nationwide inpatient sample (NIS) and included 27,444,239 pediatric inpatients (age ≤ 18 years), and 10,562 (0.04%) were managed primarily for POD. The odds ratio (OR) of the association of variables in POD inpatients was measured using the binomial logistic regression model that was adjusted for demographic confounders and psychiatric comorbidities. Results Adolescents have higher odds (OR 10.75, 95% CI 10.16-11.36) of POD-related hospitalization compared to children ≤ 12 years. Whites formed the significant proportion (67%), and those from low-income families (<50th percentile) had higher likelihood for POD-related hospitalization. The most prevalent psychiatric comorbidities were mood disorders (44.3%) and anxiety disorders (14.6%). Prevalent comorbid substance use disorders (SUDs) included cannabis (14.2%), tobacco (13.1%), and opioid (9.4%). A higher odds of association with POD-related hospitalizations were seen in pediatric inpatients with comorbid opioid (

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Section: Discussionmentioning

confidence: 99%

Recreational Cannabis Use and Risk of Prescription Opioid Overdose: Insights from Pediatric Inpatients

Pankaj

Oraka²,

Caraballo-Rivera

et al. 2020

Cureus

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“…Another important aspect is that the treatment of OUD in adolescents differs from than in adults. OAT is strongly recommended because of the high risk of overdose and death associated with continued opioid use 14,17,18 . Moreover, randomized controlled trials for OAT in adolescents with OUD have only been conducted for buprenorphine 17 .…”

Section: Discussionmentioning

confidence: 99%

A Case Report: Rapid Micro‐Induction of Buprenorphine/Naloxone to Administer Buprenorphine Extended‐Release in an Adolescent With Severe Opioid Use Disorder

et al. 2020

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Background and Objectives Buprenorphine extended‐release (BUP‐XR) is a monthly injectable form of opioid agonist therapy. Before its administration, a minimum 7‐day induction period with a transmucosal buprenorphine‐containing product is recommended. Methods Case report (n = 1). Results A 16‐year‐old female with active, severe opioid use disorder (OUD) and stimulant use disorder, hepatitis C virus, co‐occurring mental health disorders, and complex social stressors had five recent overdoses requiring naloxone. She had previously been treated with methadone and several trials of sublingual buprenorphine/naloxone, but would quickly discontinue the treatment. Using a rapid micro‐induction protocol, buprenorphine/naloxone was administered for 3 days. On day 4, 300 mg BUP‐XR was administered subcutaneously. Minimal withdrawal symptoms occurred, despite recent fentanyl use. Discussion and Conclusions A rapid sublingual buprenorphine/naloxone micro‐induction was successfully used to initiate BUP‐XR, thereby eliminating the abstinence period prior to buprenorphine/naloxone administration, shortening the induction period, and minimizing withdrawal. Scientific Significance This is the first reported case of using rapid micro‐induction as a bridge to initiate BUP‐XR. By reducing the length of induction to 4 days and minimizing withdrawal, this induction method can make BUP‐XR more accessible to patients who would otherwise refuse the medication due to concerns of enduring withdrawal. (Am J Addict 2020;29:531–535)

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“…Therefore, improving physicians’ prescription practices is a critical way to reduce the heroin addiction problem. Furthermore, pediatric providers should discuss the importance of safe medication storage with guardians, as this is another essential way of reducing this problem [23]. Parents or guardians who are on prescribed opioid should be advised to keep these medications away from their children’s reach [23].…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, pediatric providers should discuss the importance of safe medication storage with guardians, as this is another essential way of reducing this problem [23]. Parents or guardians who are on prescribed opioid should be advised to keep these medications away from their children’s reach [23]. Additionally, another way to reduce the overdose prevalence is by medication-assisted treatment (MAT), i.e., a combined use of methadone, buprenorphine, or naltrexone for heroin addicts [20].…”

Section: Discussionmentioning

confidence: 99%

Heroin Overdose-Related Child and Adolescent Hospitalizations: Insight on Comorbid Psychiatric and Substance Use Disorders

Queeneth

Bhimanadham

Mainali

et al. 2019

Behavioral Sciences

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Objective: To evaluate the association between psychiatric comorbidities, substance use disorders and heroin overdose-related hospitalizations (HOD). Next, to understand the demographic trend of HOD hospitalizations and comorbidities. Methods: Using the Nationwide Inpatient Sample (NIS), we included 27,442,808 child and adolescent hospitalizations, and 1432 inpatients (0.005%) were managed primarily for HOD. The odds ratio (OR) of the association of variables in HOD inpatients were measured using a logistic regression model. Results: Adolescents had 56 times higher odds (95% CI 43.36–73.30) for HOD-related hospitalizations compared to 4.6% children under 11 years. About three-fifth of the HOD inpatients were male, and they had 1.5-fold higher odds (95% CI 1.30–1.64) compared to 43% females in the study population. Whites were considerably higher in proportion (81%) than other race/ethnicities. A greater portion of HOD inpatients (40%) were from high-income families. Most common comorbid psychiatric disorders were mood (43.8%) and anxiety (20.4%). The prevalent comorbid substance use disorders were opioid (62.4%), tobacco (36.8%) and cannabis (28.5%) use disorders. Conclusion: HOD-related hospitalizations were predominant in males, White and older adolescents (12–18 years). Prescription opioids are the bridge to heroin abuse, thereby increasing the vulnerability to other substance abuse. This requires more surveillance and should be explored to help reduce the heroin epidemic in children.

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Opioid Use Disorders in Adolescents—Updates in Assessment and Management

Cited by 22 publications

References 56 publications

Recreational Cannabis Use and Risk of Prescription Opioid Overdose: Insights from Pediatric Inpatients

Recreational Cannabis Use and Risk of Prescription Opioid Overdose: Insights from Pediatric Inpatients

A Case Report: Rapid Micro‐Induction of Buprenorphine/Naloxone to Administer Buprenorphine Extended‐Release in an Adolescent With Severe Opioid Use Disorder

Heroin Overdose-Related Child and Adolescent Hospitalizations: Insight on Comorbid Psychiatric and Substance Use Disorders

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