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Lisa Black

A Pediatrics study assessed the safety, prevalence, and prescribers of opioid prescriptions to U.S. children and young adults aged 0-21 years in 2019. The study, “Opioid Prescribing to U.S. Children and Young Adults in 2019,” published in the September 2021 Pediatrics (published on Aug. 16), analyzed a national prescription dispensing database representing 92% of U.S. pharmacies. The authors found that 4 million opioid prescriptions were dispensed to children and young adults in 2019. Almost half of these prescriptions had “high-risk” patterns that increase the chance of harmful events such as overdose and opioid misuse. For example, 42% of prescriptions to patients new to opioids exceeded a 3-day supply, while 1 in 6 prescriptions to young children aged 0-11 years were for codeine or tramadol even though the FDA has issued a black box warning against using these medications in young children. The authors estimate that 6.3% of U.S. adolescents and young adults were prescribed opioids in 2019.  Dentists and surgeons wrote 60% of the 4 million opioid prescriptions, while the top 5% of prescribers wrote over half. These same “high-frequency” prescribers also wrote over half of all high-risk prescriptions, suggesting that these prescribers potentially should be targeted in efforts to improve the safety of opioid prescribing to children and young adults.


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.

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