Children’s Hospital Los Angeles Surgeon Establishes First-Ever Guidelines for Pediatric Opioid Prescribing

Pediatric surgeon Lorraine Kelley-Quon, MD, MSHS, and a diverse team of health care providers and advocates have established the first guidance for pediatric opioid prescriptions, outlining 20 guidelines for safer pain management in children and adolescents.

Kelley-Quon cites a CDC report revealing that approximately 9% of teens between the ages of 15 and 19 received an opioid prescription in 2018. Prescription medications are concerning in this age group due to recreational use and easy access to sharing with friends. Furthermore, research shows that deaths due to opioid overdose are on the rise for all age groups.

“Opioids can be very effective in pain management following pediatric procedures, but we need to work with the medical community to ensure they are used safely and judiciously,” Kelley-Quon said in a press release.

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Kelley-Quon led an effort to develop evidence-based guidelines for best practices in opioid prescribing, completing an extensive review of scientific and medical publications beyond literary searches, according to the press release. A multidisciplinary group was created, including specialists in pediatric surgery, pediatric anesthesia, and addiction science, and included other key stakeholders representing nursing, physician assistants, surgery trainees, and family advocates. The entire group then met and constructed the guidelines together after pooling data from published studies.

Three basic tenets were created by the team, which all the guidelines fall in:

• A recognition that misuse of prescription opioids is a problem to be taken seriously when caring for children and adolescents.
• Acknowledge there are many non-opioid medications that have excellent data supporting their use for children who require surgery.
• Health care providers must educate patients and families before and after surgery about what an opioid is, what the risks are, and how they should be safely stored and disposed of

“With these guidelines, we didn’t want to suggest that opioids should never be used,” Kelley-Quon said in a press release. “Instead, we wanted to impart the idea that they need to be used in a thoughtful way.”

The publication sets the stage to begin shaping policies around prescribing opioids in pediatric medicine, especially being endorsed by the American Pediatric Surgical Association, but Kelley-Quon noted that more work is needed.

“We are laying the groundwork,” Kelley-Quon said in a press release. “It is our hope that this work will change paradigms in pain management for children and teens by increasing surgeon awareness and facilitating family engagement.”

REFERENCE

Children’s Hospital Los Angeles surgeon establishes first-ever guidelines for pediatric opioid prescribing. Children’s Hospital Los Angeles. https://www.chla.org/press-release/children-s-hospital-los-angeles-surgeon-establishes-first-ever-guidelines-pediatric. Published November 11, 2020. Accessed November 13, 2020.