Nearly half of pediatric opioid prescriptions are high risk

Of the more than 4 million opioid prescriptions written for children and young adults under 21 in 2019, 45.6 percent fit high-risk patterns that could increase instances of misuse and overdose, according to a study published in the August 2021 issue of Pediatrics.

Researchers identified opioid prescriptions dispensed to Americans under 21 in 2019 using the IQVIA Longitudinal Prescription Database, which captures 92 percent of U.S. pharmacies.

The research team found that 41.8 percent of these prescriptions were for more than a three-day supply. They also found that 1 in 6 prescriptions written for children under 12 were for either codeine or tramadol, even though the FDA has issued a black box warning against young children taking these drugs.

Dentists and surgeons wrote 61.4 percent of all opioid prescriptions written for Americans under 21 in 2019. High-volume prescribers, defined as those with prescription counts at the 95th percentile or above, wrote 53 percent of them.

"Reducing opioid prescribing by dentists and surgeons could substantially lower prescription opioid exposure in children and young adults," the researchers wrote. "To improve the safety of pediatric opioid prescribing, initiatives targeting high-volume prescribers may be warranted. However, broad-based initiatives are also needed to address the large share of high-risk prescribing attributable to other prescribers."

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