Inappropriate Opioid Dosing and Prescribing for Children: An Unintended Consequence of the Clinical Pain Score?

n recent years, policy makers and clinicians across the country have been confronted with unprecedented rates of opioid-related adverse events, overdose, and death in our communities. Children, adolescents, and young adults are particularly vulnerable to such outcomes, as evidenced by a dramatic increase in the numbers of hospitalizations and accidental deaths.1 Recent efforts aimed at reducing adverse opioid outcomes have included enhanced regulation and monitoring of opioid prescribing, development and promotion of tamper-resistant drug formulations, expanded access to naloxone, and guidance for appropriate opioid prescribing for chronic pain. Although it is too early to determine the broad impact of these strategies, opioid-related morbidity and mortality appear to be largely unrelenting. Furthermore, while these efforts may reduce some of the morbidity associated with long-term use, addiction, and diversion, they may do little to address opioid-related toxicity and misuse that is particularly germane to children and adolescents.

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