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Opioid-prescribing Patterns for Pediatric Patients in the United States

Groenewald, Cornelius B. MBChB

The Clinical Journal of Pain: June 2019 - Volume 35 - Issue 6 - p 515–520
doi: 10.1097/AJP.0000000000000707
Special Topic Series on Opioid Therapeutics and Concerns in Pediatrics

Background and Objectives: The opioid crisis in America affects both adults and children. However, knowledge about the epidemiology of the opioid crisis, opioid prescribing patterns, and the link between opioid prescribing and problematic opioid behaviors remain limited. Thus, children are often excluded from health care policies and guidelines aimed at curbing the opioid crises. The primary aim of this topical review is to provide a brief overview of the opioid crises affecting children, followed by a synopsis of recent research on opioid prescribing patterns and data on the links between legitimate opioid use and risk for problematic opioid use behaviors.

Methods: This is a narrative review.

Results: Opioid misuse is a public health crisis facing children and adolescents in the United States and serves as a key antecedent for other problematic opioid behaviors, including opioid use disorder, heroin use, and opioid overdose. Furthermore, the United States experienced a significant increase in opioid prescribing to children and adolescents as compared with prescribing rates before the year 2000. Yet, data on the associations between opioid prescribing patterns and risk for problematic opioid use remains limited.

Discussion: There exist an urgent need to identify adolescents at increased risk for problematic opioid use behaviors following a receipt of medically prescribed opioids. The article closes with some general guidelines that providers may follow to reduce the risk of opioids in pediatric patients.

Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA

The authors declare no conflict of interest.

Reprints: Cornelius B. Groenewald, MBChB, Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, 4800 Sand Point Way NE, Seattle, WA 98105 (e-mail:

Received February 8, 2019

Received in revised form February 11, 2019

Accepted February 13, 2019

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.