US Pharm. 2019;44(3):33-35.

According to a new study by researchers at Children’s Hospital of Philadelphia (CHOP), opioid drugs prescribed to children for pain after a typical pediatric orthopedic procedure may be significantly overprescribed. The patients used less than 25% of the drugs, suggesting a potential risk of opioid diversion. The findings were published on January 16, 2019, in the Journal of Bone and Joint Surgery.

Opioid diversion and nonmedical use of opioids are tremendous challenges as the medical community strives to achieve improved opioid stewardship. This is especially true in orthopedics. Across the country, more than half of all opioid prescriptions were given to patients by orthopedic surgeons.

Additionally, about 40% of adolescents who took opioids for nonmedical reasons had access to them from leftover prescriptions. Adolescents are also more likely to abuse substances as adults if they have used opioids for both medical and non-medical reasons. While younger children are less likely to abuse opioids, accidental ingestion is on the rise and can result in significant injury or death.

“When we’re prescribing analgesic opioids for young patients, we not only want to avoid overtreating this group of patients but we also want to make sure we’re not undertreating pain as they recover from surgery,” said Apurva Shah, MD, MBA, an orthopedic surgeon at CHOP, co-director of the Brachial Plexus Injury Program and lead author of this study.