Trends in opioid prescriptions among children and adolescents in the United States

Groenewald, Cornelius B.; Rabbitts, Jennifer A.; Gebert, J. Thomas; Palermo, Tonya M.

doi:10.1097/j.pain.0000000000000475

Cited by 88 publications

(111 citation statements)

References 24 publications

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“…Over the past 2 decades, prescription of opioids has increased dramatically in the USA and less so in other countries . In a study based on a national surveys of office‐based physicians, the visits that included an opioid prescription increased from 0.65% in 1995‐1998 to 2.63% in 2007‐2010 .…”

Section: Introductionmentioning

confidence: 99%

“…Over the past 2 decades, prescription of opioids has increased dramatically in the USA and less so in other countries. [1][2][3][4][5][6][7][8] In a study based on a national surveys of office-based physicians, the visits that included an opioid prescription increased from 0.65% in 1995-1998 to 2.63% in 2007-2010. 5 This increase has been associated with concurrent increases in misuse of these medications, increased morbidity, and higher rates of mortality due to opioid overdose.…”

Section: Introductionmentioning

confidence: 99%

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National trends in long‐term use of prescription opioids

Mojtabai

2017

Pharmacoepidemiology and Drug

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

National trends in long‐term use of prescription opioids

Mojtabai

2017

Pharmacoepidemiology and Drug

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“…Codeine use remains prevalent in emergency departments ; however, no studies have yet examined codeine use in the general childhood population. We previously examined opioid use among children in the USA and found that codeine constituted 39.9% of opioids used by children in 2012 . The current study analyses this data further by examining patterns and predictors of codeine use among children in the USA between 1996 and 2013.…”

Section: Introductionmentioning

confidence: 90%

Codeine use among children in the United States: a nationally representative study from 1996 to 2013

Livingstone

Groenewald

Rabbitts

et al. 2016

Pediatric Anesthesia

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Background Concerns regarding the safety of codeine have been raised. Cases of life-threatening respiratory depression and death in children have been attributed to codeine’s polymorphic metabolic pathway. International health agencies recommend restricted use of codeine in children. Despite these recommendations, the epidemiology of codeine use among children remains unknown. Aims Our objective was to examine patterns of codeine use in the US among children. Methods A cross-sectional analysis of children ages 0–17 years from 1996–2013 in the US was performed. Data was extracted from MEPS, a nationally representative set of health care surveys. Prevalence rates of codeine use between 1996 and 2013 were examined. Multivariable logistic regression examined relationships between codeine use and patient demographics. Results Codeine use remained largely unchanged from 1996 to 2013 (1.08 vs. 1.03 million children, respectively). Odds of codeine use was higher in ages 12–17 (OR, 1.40; [1.21–1.61]), outside of the Northeast US, and among those with poor physical heath status (OR, 3.29 [1.79–6.03]). Codeine use was lower in children whose ethnicity was not white and those uninsured (OR, 0.47 [0.34–0.63]). Codeine was most frequently prescribed by emergency physicians (18%) and dentists (14%). The most common condition associated with codeine use was trauma-related pain. Conclusions Pediatric codeine use has declined since 1996, however more than 1 million children still used codeine in 2013. Health care providers must be made aware of guidelines advising against the use of codeine in children. Codeine is potentially hazardous and safer alternatives to treat children’s pain are available.

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“…In 2013, the FDA added a black‐box drug label warning emphasizing the increased risk of serious adverse effects and death in children with the UM phenotype treated with codeine following tonsillectomy and/or adenoidectomy. Still, codeine remains a frequently prescribed opioid in children younger than 18 years . Safe and effective use of codeine may be achieved with dosing adjustments or alternative medication selection based, in part, on preemptive personalized CYP2D6 PGx information.…”

Section: Complexities Of Pgx Testingmentioning

confidence: 99%

Collaborative Counseling Considerations for Pharmacogenomic Tests

Zierhut

Campbell

Mitchell³

et al. 2017

Pharmacotherapy

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Increased use of pharmacogenomic (PGx) testing in the clinical setting has revealed a number of challenges to providing this service. PGx is an important component of precision medicine that brings together the fields of genetics and clinical pharmacology. A model that incorporates a multidisciplinary approach to implementation and information delivery may be the most beneficial to patients and providers. In this review, translational considerations in the provision of PGx testing and counseling services are described. Specifically, we report on the selection of PGx tests, the provision of patient education and counseling, and examples of PGx service delivery models that incorporate counseling by pharmacists and genetic counselors. Examples of ancillary risks associated with PGx testing, testing of children, and familial implications of testing are reviewed. Through multispecialty partnerships, including genetic counselors and pharmacists, implementation obstacles to PGx testing can be overcome to provide quality precision medicine to patients.

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Trends in opioid prescriptions among children and adolescents in the United States

Cited by 88 publications

References 24 publications

National trends in long‐term use of prescription opioids

National trends in long‐term use of prescription opioids

Codeine use among children in the United States: a nationally representative study from 1996 to 2013

Collaborative Counseling Considerations for Pharmacogenomic Tests

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