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Trends in prescription opioid use in pediatric emergency department patients.
Pediatr Emerg Care. 2014 Apr; 30(4):230-5.PE

Abstract

OBJECTIVE

In recent years, there has been increased emphasis on treating pain in emergency departments (EDs), coinciding with mounting concerns regarding the abuse potential of prescription opioids. In this study, we describe trends in opioid prescribing in pediatric patients in the US EDs over the past decade.

METHODS

Data from the 2001-2010 National Hospital Ambulatory Medical Care Survey were analyzed and pain-related visits were identified. Pain-related ED visits by pediatric patients (≤19 y) where an opioid analgesic was administered or prescribed were tabulated by age category and year. Specific opioids analyzed included codeine, hydrocodone, hydromorphone, morphine, and oxycodone. The use patterns of nonopioid pain relievers were also investigated. Results were further stratified by Drug Enforcement Agency schedule and pain-related diagnosis.

RESULTS

The overall use of opioid analgesics in pain-related pediatric ED visits increased from 11.2% to 14.5% between 2001 and 2010 (P = 0.015). The use of Drug Enforcement Agency schedule II agents doubled from 3.6% in 2001 to 7.0% in 2010 (P < 0.001), whereas there was no significant increase in the use of schedule III, IV, and V agents (P = 0.34). Hydrocodone was the most frequently prescribed opioid analgesic. Increased opioid use was most dramatic in ED visits that involved adolescents. There was no significant increase in the use of nonopioid analgesics in pediatric ED patients (P = 0.086).

CONCLUSIONS

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.

Authors+Show Affiliations

From the *Department of Emergency Medicine, The George Washington University; †The George Washington University School of Medicine and Health Sciences; ‡Department of Pediatrics, The George Washington University; and §Department of Clinical Pharmacology, Children's National Medical Center, Washington, DC.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24651218

Citation

Mazer-Amirshahi, Maryann, et al. "Trends in Prescription Opioid Use in Pediatric Emergency Department Patients." Pediatric Emergency Care, vol. 30, no. 4, 2014, pp. 230-5.
Mazer-Amirshahi M, Mullins PM, Rasooly IR, et al. Trends in prescription opioid use in pediatric emergency department patients. Pediatr Emerg Care. 2014;30(4):230-5.
Mazer-Amirshahi, M., Mullins, P. M., Rasooly, I. R., van den Anker, J., & Pines, J. M. (2014). Trends in prescription opioid use in pediatric emergency department patients. Pediatric Emergency Care, 30(4), 230-5. https://doi.org/10.1097/PEC.0000000000000102
Mazer-Amirshahi M, et al. Trends in Prescription Opioid Use in Pediatric Emergency Department Patients. Pediatr Emerg Care. 2014;30(4):230-5. PubMed PMID: 24651218.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Trends in prescription opioid use in pediatric emergency department patients. AU - Mazer-Amirshahi,Maryann, AU - Mullins,Peter M, AU - Rasooly,Irit R, AU - van den Anker,John, AU - Pines,Jesse M, PY - 2014/3/22/entrez PY - 2014/3/22/pubmed PY - 2014/12/17/medline SP - 230 EP - 5 JF - Pediatric emergency care JO - Pediatr Emerg Care VL - 30 IS - 4 N2 - OBJECTIVE: In recent years, there has been increased emphasis on treating pain in emergency departments (EDs), coinciding with mounting concerns regarding the abuse potential of prescription opioids. In this study, we describe trends in opioid prescribing in pediatric patients in the US EDs over the past decade. METHODS: Data from the 2001-2010 National Hospital Ambulatory Medical Care Survey were analyzed and pain-related visits were identified. Pain-related ED visits by pediatric patients (≤19 y) where an opioid analgesic was administered or prescribed were tabulated by age category and year. Specific opioids analyzed included codeine, hydrocodone, hydromorphone, morphine, and oxycodone. The use patterns of nonopioid pain relievers were also investigated. Results were further stratified by Drug Enforcement Agency schedule and pain-related diagnosis. RESULTS: The overall use of opioid analgesics in pain-related pediatric ED visits increased from 11.2% to 14.5% between 2001 and 2010 (P = 0.015). The use of Drug Enforcement Agency schedule II agents doubled from 3.6% in 2001 to 7.0% in 2010 (P < 0.001), whereas there was no significant increase in the use of schedule III, IV, and V agents (P = 0.34). Hydrocodone was the most frequently prescribed opioid analgesic. Increased opioid use was most dramatic in ED visits that involved adolescents. There was no significant increase in the use of nonopioid analgesics in pediatric ED patients (P = 0.086). CONCLUSIONS: 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. SN - 1535-1815 UR - https://www.unboundmedicine.com/medline/citation/24651218/Trends_in_prescription_opioid_use_in_pediatric_emergency_department_patients_ L2 - http://dx.doi.org/10.1097/PEC.0000000000000102 DB - PRIME DP - Unbound Medicine ER -