Trends in Prescription Opioid Use in Pediatric Emergency Department Patients

Mazer‐Amirshahi, Maryann; Mullins, Peter M.; Rasooly, Irit R.; Anker, John N. van den; Pines, Jesse M.

doi:10.1097/pec.0000000000000102

Cited by 70 publications

(77 citation statements)

References 32 publications

(45 reference statements)

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“…The available evidence concerning the benefits and harms of long-term opioid therapy in children and adolescents is limited, and few opioid medications provide information on the label regarding safety and effectiveness in pediatric patients. However, observational research shows significant increases in opioid prescriptions for pediatric populations from 2001 to 2010 (36), and a large proportion of adolescents are commonly prescribed opioid pain medications for conditions such as headache and sports injuries (e.g., in one study, 50% of adolescents presenting with headache received a prescription for an opioid pain medication [37,38]). Adolescents who misuse opioid pain medication often misuse medications from their own previous prescriptions (39), with an estimated 20% of adolescents with currently prescribed opioid medications reporting using them intentionally to get high or increase the effects of alcohol or other drugs (40).…”

Section: Scope and Audiencementioning

confidence: 99%

CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016

Haegerich²,

2016

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Section: Scope and Audiencementioning

confidence: 99%

CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016

Haegerich²,

2016

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“…In 2012, there were as many opioid prescriptions written (259 million) as there were adults in the US (Paulozzi, Mack, & Hockenberry, 2014). Prescriptions for opioids have increased significantly in adult (Mazer-Amirshahi, Mullins, Rasooly, van den Anker, & Pines, 2014) and pediatric emergency departments (Mazer-Amirshahi, Mullins, Rasooly, van den Anker, & Pines, 2014), and ambulatory settings (Olfson, Wang, Iza, Crystal, & Blanco, 2013). A study of trends in prescription medication use and abuse among college students found evidence for significant increases in prescriptions for stimulants and decreases in opioid prescriptions among college students from 2003-2013; during that time, rates of stimulant abuse increased, while rates of opioid abuse decreased (McCabe, West, Teter, & Boyd, 2014).…”

Section: Epidemiology Of Prescription Drug Abusementioning

confidence: 99%

Prescription drug abuse: from epidemiology to public policy

McHugh

Nielsen

Weiss

2015

Journal of Substance Abuse Treatment

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Prescription drug abuse has reached an epidemic level in the United States. The prevalence of prescription drug abuse escalated rapidly beginning in the late 1990s, requiring a significant increase in research to better understand the nature and treatment of this problem. Since this time, a research literature has begun to develop and has provided important information about how prescription drug abuse is similar to, and different from the abuse of other substances. This introduction to a special issue of the Journal of Substance Abuse Treatment on prescription drug abuse provides an overview of the current status of the research literature in this area. The papers in this special issue include a sampling of the latest research on the epidemiology, clinical correlates, treatment, and public policy considerations of prescription drug abuse. Although much has been learned about prescription drug abuse in recent years, this research remains in early stages, particularly with respect to understanding effective treatments for this population. Future research priorities include studies on the interaction of prescription drugs with other licit and illicit substances, the impact of prescription drug abuse across the lifespan, the optimal treatment for prescription drug abuse and co-occurring conditions, and effective public policy initiatives for reducing prescription drug abuse.

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“…In addition to adverse drug-drug reactions due to polypharmacy, it makes it increasingly difficult for patients to correctly manage these prescriptions, which may lead to unintentional poisonings. There has also been a rapid rise of opioid prescription rates in all age groups and rates of illicit drug use are higher in this age group as opposed to adults older than 65 years [21][22][23][24]. This may have contributed to the increase in visits for this demographic as some studies have found the majority of unintentional ingestions involve analgesics, particularly opioids [25,26].…”

Section: Discussionmentioning

confidence: 99%

Trends in Emergency Department Resource Utilization for Poisoning-Related Visits, 2003–2011

et al. 2016

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In recent years, there has been an increase in poisoning-related emergency department (ED) visits. This study examines trends in ED resource utilization for poisoning-related visits over time. A retrospective review of data from the National Hospital Ambulatory Medical Care Survey, 2003-2011, was conducted. All ED visits with a reason for visit or ICD-9 code related to poisoning were included. We examined the number of ED visits and resources used including diagnostic studies and procedures performed, medications provided, admission rates, and length of stay. The proportion of visits involving resource use was tabulated and trends analyzed using survey-weighted logistic regression, grouping into 2-year periods to ensure adequate sample size. Of an estimated 843 million ED visits between 2003 and 2011, 8 million (0.9 %) were related to poisoning. Visits increased from 1.8 million (0.8 %) visits in [2003][2004] to 2.9 million (1.1 %) visits in 2010-2011, p = 0.001. Use of laboratory studies, EKGs, plain radiographs, and procedures remained stable across the study period. CT use was more than doubled, increasing from 5.2 to 13.7 % of visits, p = 0.001. ED length of stay increased by 35.5 % from 254 to 344 min, p = 0.001. Admission rates increased by 45.3 %, from 15.0 to 21.8 %, p = 0.046. Over the entire study period, 52.0 % of poisoned patients arrived via ambulance, and 3.0 % of patients had been discharged from the hospital within the previous 7 days. Poisoning-related ED visits increased over the 8-year study period; poisonings are resource-intensive visits and require increasingly longer lengths of ED stay or hospital admission.

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Trends in Prescription Opioid Use in Pediatric Emergency Department Patients

Abstract: Opioid use for pain-related pediatric ED visits has increased significantly from 2001 to 2010, particularly among adolescents. Emergency department providers must be vigilant in balancing pain relief with minimizing the adverse effects of opioid analgesics.

Cited by 70 publications

References 32 publications

CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016

CDC Guideline for Prescribing Opioids for Chronic Pain — United States, 2016

Prescription drug abuse: from epidemiology to public policy

Trends in Emergency Department Resource Utilization for Poisoning-Related Visits, 2003–2011

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