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15% of Children Received Opioid Prescription for Minor Conditions


About 15% of children with minor conditions received an opioid prescription each year from 1999-’14, according to a study of Tennessee children enrolled in Medicaid. Furthermore, one in 2,611 of those treated with opioids experienced an adverse event.

In light of growing national attention on opioid overdoses, researchers from Vanderbilt University School of Medicine set out to look at opioid prescriptions for relatively minor conditions. They analyzed Medicaid data on Tennessee children ages 2-17 who did not have major chronic diseases or substance use disorders and found nearly 1.4 million outpatient opioid prescriptions. They detailed their findings in the report “Outpatient Opioid Prescriptions for Children and Opioid-Related Adverse Events” (Chung CP, et al. Pediatrics. July 16, 2018,

 About 52.5% of the opioid prescriptions were for youths ages 12-17, 28% were for children ages 6-11 and 20% were for 2- to 5-year-olds. Overall, the annual percentage of prescriptions for any age started to decline after 2009, falling to 10% in 2014. Dental procedures were the most common driver of opioid prescriptions, making up about 31%, followed by outpatient procedure/surgery (25%), trauma (18%) and infections (16.5%). About 42% of the prescriptions were for hydrocodone, 40% codeine, 5% meperidine, 5% oxycodone and 3% tramadol. They found that adverse events followed about one in every 2,611 opioid prescriptions. The most common symptoms were gastrointestinal, neuropsychiatric, dermatologic and central nervous system depression. Three children died.

“These findings indicate that extra precautions may be needed when prescribing opioids to adolescents for acute, self-limited conditions, given increased likelihood of risk-taking during this developmental period,” authors wrote. They noted the study may underestimate adverse events since less serious side effects were not counted and said the ability to generalize the results to a larger population may be limited.

This study brings attention to the use of opiods, specifically in children. We as parents should always take a step back and consider the medication we are giving to our children and what are the potentials risks vs benefits. Sometimes a little acetaminophen or ibuprofen, when needed and at appropriate doses, can go a long way. Less is more.

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