Health
Westfield Health Bulletin: Opioid prescribing guidelines aim to reduce addiction and death
The experience of losing a child leaves an unimaginable hole in the heart that only those who have experienced it can understand. Although programs to combat opiate overdoses and deaths have made progress in recent years, this country's opiate crisis is needlessly causing grief to too many people. In Massachusetts alone, there will be more than 2,000 confirmed overdose deaths in 2023.
Earlier this week, the American Academy of Pediatrics released official guidance on prescribing opiates to children. Prescribers' first reaction to the opiate epidemic was to avoid prescribing. This leads to undertreatment of pain, which in itself causes problems.
Guidance on prescribing opiates to children helps clinicians understand when opiates are prescribed and how to reduce the risk of opioid use disorder, addiction, and overdose. It also addresses disparities based on language, socio-economic status, location, ethnicity, and other factors.
Extensive evidence-based research and numerous separate committees and subcommittees contributed to the first clinical guidance on prescribing opioids in children. According to the study, 8.9% of adolescents were prescribed opioids for pain in 2018, and more than half of those prescriptions were written by dentists and surgeons. The guidance states that 0.3% to 5.85% of children and youth may develop opioid use disorder within 1 year of prescription.
The purpose of this instruction is to safely prescribe pain medications to children with severe pain. We recommend prescription opiate painkillers in combination with Tylenol or ibuprofen, as well as non-drug treatments. Prescriptions should be at the lowest dose for age and weight and for no more than 5 days, unless the duration of pain is prolonged. Codeine and tramadol are not recommended for children under 12 years of age, adolescents who are obese, have sleep apnea, lung disease, post tonsillectomy, or breastfeeding mothers.
There is special guidance for children with chronic pain or those taking other sedatives. Pain palliative management is not covered by this guidance.
Always prescribe naloxone with opiates and teach caregivers when and how to use it. Educate about safe storage and disposal, keeping in mind the safety of not only the patient, but also other children and at-risk adults in the family.
The guidance concludes by recognizing the role of pediatric health care providers in treating medical conditions based on social and behavioral considerations by balancing effective pain management with the potential risks of prescribing opioids. are. The Commission's desire is to “promote reasonable and equitable pain management and optimize the care of children, youth, and families across the United States.”
It is our hope that this well-researched approach will become another effective tool to prevent the senseless loss of life and grief that families suffer as a result of opioid overdose and death.
Take care of yourself and others.
Juanita Carnes is a Westfield resident and a nurse with 38 years of experience in hospital emergency departments and urgent care facilities. She served on the Westfield Board of Health for 30 years.
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