Stories about: opioids

Expert’s Corner: Opioids, medication misuse and your practice

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Every day, 2,500 American youth misuse a prescription pain medication (i.e., take without a prescription) for the first time, according to Foundation for a Drug-Free World. Though prescription medication misuse has declined among high school students since its peak 10 years ago, it remains a health concern.

Chances are that, like most pediatricians and primary care providers (PCPs) who treat teens, you typically don’t prescribe opioids to your patients.

The biggest source of misused medications is diversion from the family medicine cabinet, and many of these medications were left over from someone else’s prescription. Even though pediatricians may not be the source, they can help prevent problems by discussing the responsible use of medications and the risk of experimenting with opioids with our adolescent patients.

Sharon Levy, MD, MPH, director of the Boston Children’s Hospital’s Adolescent Substance Abuse Program, details the why’s and how’s for this recommendation. …Read More

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“Treatment is good, prevention is better:” Keeping teens off opioids

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A wave of opioid addiction and overdose is washing across Massachusetts. Improved access to addiction treatment is one good step in stopping it, but when it comes to adolescents, keeping them off opioids to begin with would be better.

While supportive of new treatment-focused legislation, Sharon Levy, MD, MPH, director of the Adolescent Substance Abuse Program at Boston Children’s Hospital, and Massachusetts State Senator Jennifer Flanagan make a strong case for prevention in an opinion piece on WBUR’s Cognoscenti:

Teens are better off without drugs and alcohol for a multitude of reasons. Teens’ brains are still developing, making them more vulnerable to alcohol and other drugs. Kids who start drinking alcohol before age 15 are four times more likely to develop an addiction than those who begin after their 21st birthday. Compared to adults, teens are also more susceptible to the more common tolls of substance use: car crashes and other injuries, sexual assault and suicide, worsening underlying medical conditions and school failure.

Read the whole of Levy and Flanagan’s op-ed on Cognoscenti.

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Where do opioids fit in pediatric pain management?

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The approach the field of pediatrics has taken toward pain management in children has shifted dramatically over the last half century. Pediatric pain was woefully under-managed even up to the 1970s and 80s, with infants sometimes undergoing complex surgeries without perioperative or postoperative pain control.

Over the following two decades, as physicians and scientists learned more about the acute and long-term effects of pediatric pain, the pendulum swung in favor not only of pain management, but of the use of opioid medications for controlling both chronic and acute pain in both children and adults, regardless of the pain’s origin.

“With the recognition that pain had short- and long-term potential consequences, and the lack of data at the time suggesting downsides to opioids, there was a very dramatic shift,” says Neil Schechter, MD, of the Pain Treatment Service in Boston Children’s Hospital’s Department of Anesthesia, Perioperative and Pain Medicine. “We started asking, ‘If there’s no significant downside, why should children suffer unnecessarily?'”

But has the pendulum swung too far in favor of opioids? …Read More

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