Opioids: Nonmedical Use and Abuse in Older Children

ArticleinPediatrics in Review 32(4):e44-52 · April 2011with10 Reads
DOI: 10.1542/pir.32-4-e44 · Source: PubMed
Abstract
• Prescription opioids constitute most nonmedical opioid use and abuse in older children, and medical opioid use places pediatric users at increased risk for nonmedical use. • Prevalence data demonstrate that pediatric nonmedical use increases over a person's lifetime, necessitating regular, ongoing prevention and screening measures. • Pain control is the most common reason for nonmedical opioid use. • Research data indicate friends and families are the most common sources for opioid diversion, with recent medical opioid users being at higher risk to divert opioids. • Strong evidence correlates nonmedical opioid use with increased substance abuse, with a significant minority of users experiencing both opioid abuse and dependence. • Central respiratory depression/apnea, severely depressed consciousness/coma, and pinpoint pupils are signs of opioid overdose. • Pediatricians should incorporate prevention strategies into their anticipatory guidance and prescribing practices. • Pediatricians must screen for nonmedical opioid use and associated substance abuse using a combination of clinical questioning and screening tools. • Primary opioid overdose management includes appropriate airway and ventilation management, circulation support, and administration of an opioid antagonist.
    • "Additionally, a detailed patient and family history should be obtained to determine comorbidities (i.e. depression, anxiety and other risk factors such as family history of substance use disorders; Frese & Eiden, 2011; Oliver et al., 2012). Key to harm reduction is discussion about NMUPO, despite 50% of clinicians reporting they find this difficult (The National Center on Addiction and Substance Abuse [CASA], 2005). "
    [Show abstract] [Hide abstract] ABSTRACT: http://childpain.org/ppl/
    Full-text · Article · Jun 2014 · Pain management nursing: official journal of the American Society of Pain Management Nurses
    • "The National Center on Addiction and Substance Abuse at Columbia University (NCASA, 2011) has called adolescent substance misuse—including alcohol, tobacco, and other drugs—the nation's number-one health problem . The number of high school students who reported ever having misused opioids increased significantly from the beginning (8.3% of 9th graders) to the end of high school (16.3% of 12th graders), with almost 13% having misused prescription opioids in their lifetime and 3.4% currently misusing these substances (NCASA, 2011; Frese & Eiden, 2011 ). Diversion of prescription opioids is also common among pediatric nonmedical users. "
    [Show abstract] [Hide abstract] ABSTRACT: The American Society for Pain Management Nursing (ASPMN) has updated its position statement on managing pain in patients with substance use disorders. This position statement is endorsed by the International Nurses Society on Addictions (IntNSA) and includes clinical practice recommendations based on current evidence. It is the position of ASPMN and IntNSA that every patient with pain, including those with substance use disorders, has the right to be treated with dignity, respect, and high-quality pain assessment and management. Failure to identify and treat the concurrent conditions of pain and substance use disorders will compromise the ability to treat either condition effectively. Barriers to caring for these patients include stigmatization, misconceptions, and limited access to providers skilled in these two categories of disorders. Topics addressed in this position statement include the scope of substance use and related disorders, conceptual models of addiction, ethical considerations, addiction risk stratification, and clinical recommendations.
    Full-text · Article · Oct 2012
    • "The National Center on Addiction and Substance Abuse at Columbia University (NCASA, 2011) has called adolescent substance misuse—including alcohol, tobacco, and other drugs—the nation's number-one health problem . The number of high school students who reported ever having misused opioids increased significantly from the beginning (8.3% of 9th graders) to the end of high school (16.3% of 12th graders), with almost 13% having misused prescription opioids in their lifetime and 3.4% currently misusing these substances (NCASA, 2011; Frese & Eiden, 2011 ). Diversion of prescription opioids is also common among pediatric nonmedical users. "
    [Show abstract] [Hide abstract] ABSTRACT: The American Society for Pain Management Nursing (ASPMN) has updated its position statement on managing pain in patients with substance use disorders. This position statement is endorsed by the International Nurses Society on Addictions (IntNSA) and includes clinical practice recommendations based on current evidence. It is the position of ASPMN and IntNSA that every patient with pain, including those with substance use disorders, has the right to be treated with dignity, respect, and high-quality pain assessment and management. Failure to identify and treat the concurrent conditions of pain and substance use disorders will compromise the ability to treat either condition effectively. Barriers to caring for these patients include stigmatization, misconceptions, and limited access to providers skilled in these two categories of disorders. Topics addressed in this position statement include the scope of substance use and related disorders, conceptual models of addiction, ethical considerations, addiction risk stratification, and clinical recommendations.
    Full-text · Article · Sep 2012
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