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1. Between 2005 and 2015, the rate of opioid prescriptions during emergency room visits in adolescents and young adults decreased slightly, and the opioid prescribing rate n & # 39; 39 has not changed during outpatient visits.
2. Prescription opioids have been badociated with approximately half of emergency visits for dental disorders, clavicle fractures and ankle fractures in young people.
Level of evaluation of the evidence: 2 (good)
Summary of the study: The increase in abuse and abuse of opioid prescription drugs has been well described in adults, but less is known about prescribing rates and their use in adolescents and young people adults. In this retrospective study, researchers badyzed national databases of emergency and outpatient visits of young people aged 13 to 22 between 2005 and 2015 to examine trends in prescription of opioids in adolescents and young adults. Opioids were prescribed in approximately 15% of emergency department visits and 3% of outpatient clinic visits. There was a slight decrease in the opioid prescription rate among emergency visits during the study period. Dental disorders, clavicle fractures and ankle fractures were the diagnoses of erectile dysfunction usually badociated with prescription opioids.
These results are limited by data describing visits rather than individual patients. In addition, the data do not contain any information on the duration and quantity of opioid prescription. Nevertheless, the study is reinforced by its large national sample. For physicians, these findings underscore the importance of carefully considering opioid prescribing practices in adolescents and young adults and can guide future initiatives aimed at reducing excessive prescribing. opioids.
Click to read the study, published today in Pediatrics
Click to read a pediatric accompanying editorial
Relevant Reading: Prescription Opioid Exposures in Children and Adolescents in the United States: 2000-2015
In depth [retrospective cohort]: Researchers used ambulatory medical surveys of national hospitals and national ambulatory medical care to badyze data representing 197 million emergency visits and 801 million visits to outpatient clinics in the United States. Visits were included if patients were aged 13 to 22 years. Logistic regression models were used to examine the evolution over time of opioid prescriptions.
During the study period, 52 million visits (5.2%, 95% confidence interval [CI]4.9 to 5.5%) were badociated with an opioid prescription. The opioid prescribing rate for adolescents and young adults was 14.9% (95% CI: 14.4% to 15.6%) during emergency visits and 2, 8% (95% CI: 2.5% to 3.1%) during outpatient visits. During the study period, there was a slight decrease in the opioid prescribing rate among emergency visits (OR 0.96, 95% CI: 0.95 to 0.98), but not in outpatient clinics. The diagnosis of oral dysfunction most often badociated with opioid prescribing was dental disorders (59.7%, 95% CI: 41.0% to 78.4%), clavicle fractures (47.0%), 0%, 95% CI: 29.8% to 64.3%) and ankle fractures (38.1%). 95% CI: 23.8% to 52.4%).
Picture: PD
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