By Pat Anson, PNN Editor-in-Chief
Healthcare providers have become more cautious in recent years about giving opioid pain relievers to children, fearing that even short-term use could lead to lifelong addiction or even fatal overdose.
But in a review at the University of Alberta, pediatric researchers found little evidence to support a link between short-term opioid use in childhood and opioid use disorders. (OUD) later in life.
“In fact, we haven’t found much evidence to directly answer our question,” said senior author Michele Dyson, PhD, assistant professor of pediatrics in the Faculty of Medicine and Dentistry and associate director of Alberta Research. Center for Health Evidence.
“If opioids are used as directed, they can be a safe and effective pain management strategy,” she said. “In some cases, they’re really part of the best treatment plan for managing a child’s pain.
Dyson and his colleagues looked at 21 observational studies involving nearly 50 million patients under the age of 18 who were exposed to opioids for less than 14 days. Most of the studies were considered to be of low quality and did not examine the duration of opioid use.
One study showed a potential link between short-term exposure and subsequent abuse. But the researchers concluded that the results overall were not definitive because they did not specify the duration of exposure or did not have a control group. Their findings are published in the journal Pediatrics.
“There is limited evidence to determine whether short-term therapeutic opioid exposure in childhood is
definitely associated with future use of non-medical opioids or development of ED; however, this review suggests a link between lifelong therapeutic opioid use (duration unknown) and non-medical opioid use. The existing evidence on risk factors for the use of non-medical opioids or OUD after short-term therapeutic exposure is unclear, ”the researchers concluded.
Whether opioid drugs are appropriate for children is a controversial one. Earlier this year, the World Health Organization (WHO) released new guidelines recommending that opioids be used only for children who are dying or seriously ill and who are not expected to recover.
Like the Alberta study, a WHO advisory group found little good-quality research on how to treat childhood pain, but recommended that children with chronic pain be treated with physical therapy. and psychological interventions such as cognitive behavioral therapy.
An international study in The Lancet came to a very different conclusion, warning that opioid prescribing guidelines for adults are “inappropriately applied to young people.” Due to the stigma associated with opioids, researchers said childhood pain is often untreated or poorly treated, leading to chronic pain, disability and other negative consequences in adulthood.
“Healthcare professionals, young people and parents continue to hold misconceptions and believe in myths about opioid use in pediatric patients, that the media portray opioids as the bad guy and the reason under – the underlying substance abuse, ”the researchers said. “Opioids have a place in pediatric pain medicine. “
The finding contradicts a 2018 warning from the U.S. Food and Drug Administration, which said cough and cold medications containing opioids pose “serious risks” to children and should no longer be used. prescribed for patients under the age of 18.
A recent study found that opioid abuse is relatively rare among American teens and young adults. Less than 1% of those who filled an opioid prescription for the first time overdosed or developed an opioid use disorder in the next 12 months.
Conflicting advice can be confusing for parents and providers.