A Pathway to Persistent Opioid Use You May Not Have Thought About
LewisFirst, MD, MA, Editor in Chief, Pediatrics
The opioid epidemic in this country is a public health emergency that cannot be ignored.
What underlies this epidemic, especially as it relates to children and teens? Harbaugh
et al (10.1542/peds.2017-2439) decided to look at opioid refills 90 to 180 days after 13 routine surgical procedures
in teens and young adults who were opioid naïve compared to non-surgical teens and
young adult patients. Sadly, persistent opioid use was found in 4.8% of the more
than 88,000 surgical patients studied compared to 0.1% in the non-surgical teen and
young adult patients. The authors characterize the types of surgeries with most persistent
opioid use as well as risk factors for such use.
So, what might we do to reduce the chances that a young patient receiving surgery
not become opioid dependent post-op? Equally important, just how valid are the findings
in this study that used coding data on prescription refills to imply persistent opioid
use was a surgical complication of prescribing opioids for pain? We asked pediatric
surgeon Dr. Charles Snyder from Mercy Children’s Hospital in Kansas City (10.1542/peds.2017-3054) to make an editorial incision into the findings presented in this study, and his
commentary cuts into the data in terms of what we can conclude with some validity
and what we cannot. You’ll find both the study and commentary anything but a pain
to read so check both out and learn more.