Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

The opioid crisis hits children

Cherilyn Cecchini, MD
Physician
March 8, 2018
70 Shares
Share
Tweet
Share

In past years, the opioid crisis has become a topic of interest among the adult population. More recently, attention has grown surrounding the pediatric population, as well. In fact, the topic was included in the State of the Union address given by President Trump just a few weeks ago. He vowed to end the crisis and named it a “public health emergency.”

When discussing true addiction, it is important to remember that it is defined by a disruption in the social functioning of the patient. These patients will spend exorbitant amounts of time seeking and using the drug. Despite adverse effects, the patient continues to use the drug. This differs from physical dependence, which emphasizes the experience of withdrawal symptoms once a substance is discontinued after multiple exposures to the drug.

So, just how serious is this crisis in the pediatric medical world?

A recent study published by the American Academy of Pediatrics shows that teens have easy access to prescription painkillers after undergoing common surgeries that may lead teens to abuse these medications after leaving the hospital. The study completed by Dr. Calista Harbaugh, pediatric surgery research at the University of Michigan’s C.S. Mott Children’s Hospital, examined patients between the ages of 13 to 21 who were opioid naïve after operations such as hernia repair and tonsillectomy. She found that of these 90,000 privately insured patients, 1 in 20 were still getting prescriptions refilled for opioids three to six months following the operation.

Given this realization and the concern that teens have access to opioids for longer than necessary, some states have enforced limitations on the duration of opioids that a physician may prescribe. This means that physicians are only able to prescribe a five-day to a weeklong supply of the opioid medication. This approach may help prevent the development of opioid and benzodiazepine tolerance and dependence. Studies have shown that use of opioids and sedatives for more than 5 to 10 days increases the risk of fueling addiction.

Interestingly, the FDA encourages physicians to obtain adequate training for how to appropriately prescribe opioid medications. It recommends the development of straightforward guidelines for physicians to follow when prescribing opioids for pain management in patients whose pain cannot otherwise be controlled with alternative regimens.

As a resident physician, I have attended several lectures that incorporate learning about the escalation of pain management and how to achieve adequate pain relief appropriately with non-opioid and opioid medications. Oversight by an attending physician with more experience is helpful. The challenging moments arise when patients ultimately “doctor shop” and go from one doctor to another in order to seek out additional prescriptions for opioids to feed dependency. There is no formal curriculum that includes the opioid crisis or discusses how to negotiate a pain contract with a patient.

Typically, chronic pain patients are managed by a specific pain doctor or anesthesiologist in the outpatient setting. Most primary care providers will refer these patients once it becomes difficult to manage their pain or potential addiction. Pain specialists have a greater degree of training and are more apt to appropriately manage pain regimens for these patients.

Problems arise when the patient is unable to schedule an appointment at the pain clinic regularly. These patients will often land in the offices of primary practice providers. I believe that pain management specialists should mentor and lecture the primary care providers, including resident physicians, about their general approach so that these providers feel more comfortable developing pain management plans in the interim periods. This also allows for the patient to continue to access appropriate pain medications without turning to illegal avenues.

Ultimately, pediatricians must continue to bring attention to the issue and encourage the practice of limited prescriptions of opioids coupled with the use of other modalities, such as nonsteroidal anti-inflammatory drugs. Dr. Suresh, Arthur C. King professor in anesthesiology at Northwestern University Feinberg School of Medicine and chair of the Department of Pediatric Anesthesiology at Lurie Children’s Hospital of Chicago summarized the topic well by saying, “We do need to pay attention to it … it’s a silent killer.”

Cherilyn Cecchini is a pediatric resident.

Image credit: Shutterstock.com

Prev

Online ratings have me scared for the future of medicine

March 8, 2018 Kevin 10
…
Next

A patient becomes a medical student

March 8, 2018 Kevin 0
…

Tagged as: Pediatrics, Primary Care

Post navigation

< Previous Post
Online ratings have me scared for the future of medicine
Next Post >
A patient becomes a medical student

More by Cherilyn Cecchini, MD

  • Time for grieving is a necessity for medical trainees

    Cherilyn Cecchini, MD
  • What is the pediatrician’s role in marijuana use?

    Cherilyn Cecchini, MD
  • A stigma no physician can afford

    Cherilyn Cecchini, MD

Related Posts

  • Fight the opioid crisis with physician assistants

    James Cannon, PA-C
  • The miscalculated fear of an opioid crisis in Haiti

    Kenny Moise, MD
  • How do we manage pain in the era of the opioid crisis?

    Rita Agarwal, MD
  • Seeing the effects of the opioid crisis play out live

    Praveen Suthrum
  • The opioid crisis: Doctors cannot lose hope

    Linda Girgis, MD
  • How drug distributors contributed to the opioid crisis

    Rebecca Thaxton, MD

More in Physician

  • From license to loneliness: the dilemma of retired physicians

    Richard Plotzker, MD
  • Unlearning our habits: a journey from intelligence to wisdom

    Brian Sayers, MD
  • Beyond pizza and pens: National Doctors’ Day should be about saving lives

    James Young, MD
  • Maximizing physician potential: How coaching can aid in conflict resolution, enhance health care leadership and build stronger teams

    Asha Padmanabhan, MD
  • Physicians are a finite resource we need to protect

    Jack Resneck, Jr., MD
  • Tom Brady’s legacy and the importance of personal integrity in end-of-life choices

    Kevin Haselhorst, MD
  • Most Popular

  • Past Week

    • The untold struggles patients face with resident doctors

      Denise Reich | Conditions
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Beyond pizza and pens: National Doctors’ Day should be about saving lives

      James Young, MD | Physician
    • Physicians are a finite resource we need to protect

      Jack Resneck, Jr., MD | Physician
    • From clocking in to clocking out: the transition to retirement

      Debbie Moore-Black, RN | Conditions
    • How understanding cultural backgrounds can lead to better patient care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • The Titanic sinking: a metaphor for the impending collapse of medicine

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD & Shreekant Vasudhev, MD | Physician
  • Recent Posts

    • How understanding cultural backgrounds can lead to better patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • From license to loneliness: the dilemma of retired physicians

      Richard Plotzker, MD | Physician
    • Tackling the health care crisis with artificial intelligence: Combating physician and nursing shortages in the United States

      Harvey Castro, MD, MBA | Tech
    • From hope to heartbreak: a story of loss in the ICU

      Ton La, Jr., MD, JD | Conditions
    • Unlearning our habits: a journey from intelligence to wisdom

      Brian Sayers, MD | Physician
    • Lessons from an orthopedic surgery journey [PODCAST]

      The Podcast by KevinMD | Podcast

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 4 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Experts Call for PBM Transparency During Senate Hearing
  • Want to Fix Medicare Pay for Primary Care Docs? How About Two Fee Schedules?
  • OTC Narcan Approval Opens New Doors in Fight Against Opioid Crisis
  • U.S. 'Flying Blind' When It Comes to Data on Substance Use in Pregnancy
  • Fear of Family Separation a Barrier to Addiction Care During Pregnancy

Meeting Coverage

  • VTE Risk in Recurrent Ovarian Cancer Increases With More Lines of Chemotherapy
  • Obesity's Impact on Uterine Cancer Risk Greater in Younger Age Groups
  • Oral Roflumilast Effective in the Treatment of Plaque Psoriasis
  • Phase III Trials 'Hit a Home Run' in Advanced Endometrial Cancer
  • Cannabis Use Common in Post-Surgery Patients on Opioid Tapering
  • Most Popular

  • Past Week

    • The untold struggles patients face with resident doctors

      Denise Reich | Conditions
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Beyond pizza and pens: National Doctors’ Day should be about saving lives

      James Young, MD | Physician
    • Physicians are a finite resource we need to protect

      Jack Resneck, Jr., MD | Physician
    • From clocking in to clocking out: the transition to retirement

      Debbie Moore-Black, RN | Conditions
    • How understanding cultural backgrounds can lead to better patient care [PODCAST]

      The Podcast by KevinMD | Podcast
  • Past 6 Months

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
    • It’s time for C-suite to contract directly with physicians for part-time work

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD | Physician
    • The Titanic sinking: a metaphor for the impending collapse of medicine

      Aaron Morgenstein, MD & Corinne Sundar Rao, MD & Shreekant Vasudhev, MD | Physician
  • Recent Posts

    • How understanding cultural backgrounds can lead to better patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • From license to loneliness: the dilemma of retired physicians

      Richard Plotzker, MD | Physician
    • Tackling the health care crisis with artificial intelligence: Combating physician and nursing shortages in the United States

      Harvey Castro, MD, MBA | Tech
    • From hope to heartbreak: a story of loss in the ICU

      Ton La, Jr., MD, JD | Conditions
    • Unlearning our habits: a journey from intelligence to wisdom

      Brian Sayers, MD | Physician
    • Lessons from an orthopedic surgery journey [PODCAST]

      The Podcast by KevinMD | Podcast

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

The opioid crisis hits children
4 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...