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AAP Conference Preview: Protect your patients from opioid addiction :

October 7, 2016

Prescription drug abuse and overdose deaths are an epidemic, and young people are not immune.

About 467,000 adolescents ages 12-17 years engage in nonmedical use of prescription pain relievers, and 168,000 are addicted, according to the 2014 National Survey on Drug Use and Health.

In addition, 28,000 had used heroin in the past year, and an estimated 18,000 have a heroin use disorder.

Pamela Gonzalez, M.D., FAAP, will issue a call to action to pediatricians to protect their patients from this growing threat during her plenary address titled “Youth Opioid Addiction: a Part of Your Practice, So What Should You Know? (P2086)” from 11-11:20 a.m. Oct. 23 at the AAP National Conference & Exhibition in San Francisco.

Patients with the severest substance use disorder started at the youngest ages, said Dr. Gonzalez, a member of the AAP Committee on Substance Use and Prevention and assistant professor in the Department of Psychiatry at University of Minnesota.

“The patient who sees me for medication-assisted treatment at age 21 started using opioids at age 14-15,” said Dr. Gonzalez, who is board-certified in addiction medicine. “We have an opportunity to detect illness earlier, prevent progression and possibly prevent opioid use in the first place.”

During her talk, Dr. Gonzalez will urge pediatricians to take an active role in protecting young patients from unnecessary therapeutic opioid exposure from direct prescribing and from accessing pills prescribed to adults.

“Just like you would say to your own young children, ‘Use your words,’ there's no substitute for talking to children and their parents/caregivers,” Dr. Gonzalez said. “Initiate the conversation, ask the questions. Remaining silent is not going to solve any of this.”

As with any illness, pediatricians can observe features of opioid addiction such as objective signs of withdrawal, infectious disease complications and track marks in those using an IV, Dr. Gonzalez said. In addition, pediatricians can look for evidence in the teen's life. Is his academic performance suffering? Has she dropped out of activities she used to enjoy? Has her peer groups shifted? Is she withdrawing from family? Is he secretive? Are there injuries?

Most youths who start using opioids illicitly take prescription drugs that were prescribed for an adult, Dr. Gonzalez noted. Therefore, one of the keys to prevention is communicating with health professionals from other disciplines.

“Prescribing practices to adults are impacting our young patients,” Dr. Gonzalez said. “There has to be dialogue between pediatrics and adult medical, surgical and dental disciplines. I'm confident that together we can figure out how to do this.”

Dr. Gonzalez also will present “Highway to Heroin? Opiates and Other Prescriptions After Musculoskeletal Injuries (F2196)” from 5-5:45 p.m. Oct. 23.

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