American Academy of Pediatrics Updates Guidance on Opioid Dependence, Withdrawal Associated With a Medical Prescription

The American Academy of Pediatrics offers updated guidance to pediatricians on helping recognize children’s dependence on and withdrawal from opioids that stem from their use of a medical prescription. The clinical report, “Recognition and Management of Iatrogenically Induced Opioid Dependence and Withdrawal in Children,” published in the September 2025 Pediatrics (published online Aug. 18), focuses on children prescribed opioid medications for acute injuries and chronic conditions. The report does not address infants being treated for neonatal abstinence syndrome (withdrawal from prenatal drug exposure). The clinical report, an update to a prior 2014 statement, summarizes existing literature on opioid withdrawal due to the use medically prescribed opioids (iatrogenic). Prescription opioid use is prevalent in both pediatric inpatient and outpatient settings, according to AAP. Around-the-clock dosing of opioids take for as few as 5 days can produce physiologic opioid dependence and may lead children to exhibit withdrawal symptoms on abrupt discontinuation or tapering of these medications. The AAP observes that it is important not to conflate addiction, also known as an opioid use disorder, with physiological dependence or tolerance, because patients appropriately treated with prolonged opioid therapy may develop physiological dependence and sometimes tolerance. For those patients requiring opioids for longer than five days, providers should consider tapering the dose of opioid as well as assessing regularly for withdrawal symptoms. Clinical reports created by AAP are written by medical experts, reflect the latest evidence in the field, and go through several rounds of peer review before being approved by the AAP Board of Directors and published in Pediatrics. To request an embargoed copy of the clinical report or an interview with an expert, contact AAP Public Affairs.  

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults.