Opioid Prescribing for the Treatment of Acute Pain in Children on Hospital Discharge.

Opioid Prescribing for the Treatment of Acute Pain in Children on Hospital Discharge. Anesth Analg. 2017 Dec;125(6):2113-2122 Authors: Monitto CL, Hsu A, Gao S, Vozzo PT, Park PS, Roter D, Yenokyan G, White ED, Kattail D, Edgeworth AE, Vasquenza KJ, Atwater SE, Shay JE, George JA, Vickers BA, Kost-Byerly S, Lee BH, Yaster M Abstract BACKGROUND: The epidemic of nonmedical use of prescription opioids has been fueled by the availability of legitimately prescribed unconsumed opioids. The aim of this study was to better understand the contribution of prescriptions written for pediatric patients to this problem by quantifying how much opioid is dispensed and consumed to manage pain after hospital discharge, and whether leftover opioid is appropriately disposed of. Our secondary aim was to explore the association of patient factors with opioid dispensing, consumption, and medication remaining on completion of therapy. METHODS: Using a scripted 10-minute interview, parents of 343 pediatric inpatients (98% postoperative) treated at a university children's hospital were questioned within 48 hours and 10 to 14 days after discharge to determine amount of opioid prescribed and consumed, duration of treatment, and disposition of unconsumed opioid. Multivariable linear regression was used to examine predictors of opioid prescribing, consumption, and doses remaining. RESULTS: Median number of opioid doses dispensed was 43 (interquartile range, 30-85 doses), an...
Source: Anesthesia and Analgesia - Category: Anesthesiology Authors: Tags: Anesth Analg Source Type: research

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Drug overdose has become the leading cause of death in Americans under age 50, with 66% from opioid abuse, and the FDA has declared an opioid epidemic in the US. As of 2016, more than 289 million prescriptions per year were for opioids, and 12-17 year olds were one-third of all new abusers. The majority of patients seen by oral and maxillofacial surgeons (OMS) for wisdom tooth removal fall into this age group, and OMSs commonly prescribe opioids for several days for post-operative analgesia. However, as more evidence is presented, it is apparent that opioids may not be required routinely, and adequate pain control may be a...
Source: Journal of Oral and Maxillofacial Surgery - Category: ENT & OMF Authors: Tags: Anesthesia Abstract Session Source Type: research
Conclusion: This anesthetic prescription can be useful for opioid-naïve patients as well as for patients with chronic pain that is managed with opioids. PMID: 30258291 [PubMed]
Source: Ochsner Journal - Category: General Medicine Tags: Ochsner J Source Type: research
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Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions Surgery Source Type: blogs
A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. Every physician takes the Hippocratic oath and promises to “do no harm.” In the face of the current opioid epidemic, this includes protecting our patients from dependence and addiction, including those who are suffering from debilitating acute and chronic pain. Sometimes this involves getting creative as we develop treatment plans. Luckily, opioids are not the only, nor always the best, defense against pain. One patient who avoided the negative side effects of long-term opioid use was Beth Hunt. Beth was living life...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Conditions Pain Management Surgery Source Type: blogs
Conclusions: In a population at risk for persistent opioid use, prescription often exceeds patients’ needs. Guidelines for opioid prescribing in the setting of multimodal anesthetic regimens may allow us to lessen our contribution to the opioid epidemic. Further research on patients with chronic pain, patients with chronic opioid use, and the role of patient education is needed.
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Source: Medgadget - Category: Medical Devices Authors: Tags: Anesthesiology Medicine Pain Management acutepain chronicpain Source Type: blogs
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