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It is time for someone to say this out loud. “We should not use opioids for back pain.”

Back pain is a common and sometimes disabling condition that af...

No Opioids for Back Pain. Period.

August 16, 2016

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Poisoning our children

October 4, 2016

In my last blog I talked about opioid babies.  This week I want to look at our children (ages 2-21) and opioids.

 

Previously, I discussed how opioid babies are born with physical dependence to opioids because of their mother’s opioid use.  They are not addicted. Addiction is a chronic brain disease that is manifested by drug craving and characteristic behaviors. Addiction is a life threatening disease without a cure. However, unlike opioid babies, our children may become addicted by the prescribing of opioids by our medical and dental professionals.

 

The disease of opioid addiction in children has become such a problem that the American Academy of Pediatrics recently released their recommendations for the use of medications in children with opioid use disorder. (AAP, 2016). Neuroscientists tell us that a child’s developing brain is very sensitive to any addicting substance. There is a great story that aired on NPR’s Fresh Air about this, which I encourage you to read here. Science has shown that opioids have a similar effect–even when taking a legitimate prescription–causing brain changes that increase the risk of future abuse and addiction (Miech, Johnston, O’Malley, Keyes, & Heard, 2015).

 

A 2011 study looked at how many children with a complaint of pain (headache or pain in the back, neck or joints) received an opioid prescription. Researchers found that for those with commercial insurance, 21% of children with pain received an opioid prescription. When looking at the Arkansas Medicaid population, those researchers  found that 40% of children with these complaints received an opioid (Richardson et al., 2011).

 

Athletes are particularly at risk. A recent study found that adolescent males who participate in sports are almost twice as likely as their non-sport peers to receive an opioid prescription; these athletes are also ten times more likely to misuse opioid pain medication (Veliz et al., 2014). This is especially tragic since there are more effective options to treat pain than using opioids.

 

Scientific studies overwhelmingly confirm that nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen are more effective in treating pain than oral opioids. What’s more, the combination of any NSAID and acetaminophen is better yet (Teater, 2014). We also know that opioids are commonly prescribed to our children and are changing their brains in ways that predispose them to the devastating disease of addiction. For these reasons, we must stop prescribing opioid medications to our children unless there are truly exceptional situations.

 

References:

 

AAP COMMITTEE ON SUBSTANCE USE AND PREVENTION. (2016). Medication-Assisted Treatment of Adolescents With Opioid Use Disorders. Pediatrics, 89(5), 577–581. http://doi.org/10.1542/peds.2016-1893

 

Miech, R., Johnston, L., O’Malley, P. M., Keyes, K. M., & Heard, K. (2015). Prescription Opioids in Adolescence and Future Opioid Misuse. Pediatrics, 136(5). http://doi.org/10.1542/peds.2015-1364

 

Richardson, L. P., Fan, M. Y., McCarty, C. A., Katon, W., Edlund, M., DeVries, A., … Sullivan, M. (2011). Trends in the prescription of opioids for adolescents with non-cancer pain. General Hospital Psychiatry, 33(5), 423–428. http://doi.org/10.1016/j.genhosppsych.2011.04.009

 

Teater, D. (2014). Evidence for the efficacy of pain medications. Itasca, Illinois. Retrieved from http://media.wix.com/ugd/cb52b5_8a3726bdfc2c47fa9da81547e622cb45.pdf

 

Veliz, P., Epstein-Ngo, Q. M., Meier, E., Ross-Durow, P. L., McCabe, S. E., & Boyd, C. J. (2014). Painfully obvious: A longitudinal examination of medical use and misuse of opioid medication among adolescent sports participants. Journal of Adolescent Health, 54(3), 333–340. http://doi.org/10.1016/j.jadohealth.2013.09.002

 

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