Adolescents and young adults received opioids in about 15% of emergency department (ED) visits, according to a new study.
The study is one of two on opioid prescribing trends released today in Pediatrics as concerns escalate about misuse of the drugs, especially among young people.
Researchers analyzed nationally representative survey data from 2005-’15 for adolescents (13-17 years) and young adults (18-22 years). They determined that just over 52 million or 5% of ED and outpatient clinic visits were associated with an opioid prescription.
Opioids were prescribed in about 15% of ED visits and 3% of outpatient clinic visits, according to “Trends in Opioid Prescribing for Adolescents and Young Adults in Ambulatory Care Settings” (Hudgins JD, et al. Pediatrics. May 28, 2019, https://doi.org/10.1542/peds.2018-1578). In ED settings, there was a small but significant decrease in opioid prescriptions over the course of the study.
Among adolescents, 3% of ED or outpatient clinic visits resulted in an opioid prescription. Family practices and orthopedic surgery clinics were associated with the most prescriptions in outpatient settings, while the highest rates were for general surgery and orthopedic surgery clinics. In the ED, teens received the greatest number of prescriptions for ankle sprains and abdominal pain, while the highest rates were for dental disorders (60%) and clavicle fractures (47%).
About 7.5% of ED and outpatient clinic visits resulted in an opioid prescription for young adults. Family practice clinics and those classified as “other specialties” like gastroenterology and hematology prescribed the highest number of prescriptions in outpatient clinic settings. These specialty clinics also had some of the highest prescribing rates along with orthopedic surgery. In the ED, young adults had the highest numbers of opioid prescriptions for abdominal pain and dental disorders and the highest rates for dental disorders (58%) and low back pain (38%).
“These findings inform targeted interventions and educational programs aiming to ensure judicious use of opioids in adolescents and young adults,” authors wrote.
In another study released today, researchers looked at 2.6 million children and youths with special health care needs enrolled in Medicaid in 2016. They found 7.4% filled an opioid prescription in an outpatient setting compared to 3.5% of children without a special health care need. Among children with a complex chronic condition, 14% had filled an opioid prescription.
The most common conditions prompting an opioid prescription were infections and injuries, and prescriptions often were preceded by a visit to an ED or outpatient surgery, according to “Outpatient Prescription Opioid Use in Pediatric Medicaid Enrollees With Special Healthcare Needs,” (Feinstein JA, et al. Pediatrics. May 28, 2019, https://doi.org/10.1542/peds.2018-2199).
Authors called for the development of guidelines for opioid prescribing and follow-up evaluation for children and youths with special health care needs.