More adolescents arriving in ERs for opioid abuse; risk of addiction averages 50 times higher for youths after surgery

More adolescents arriving in ERs for opioid abuse; risk of addiction averages 50 times higher for youths after surgery

A study of nearly 90,000 pediatric patients, ages 13 to 21 years, has found that new, persistent opioid use following surgery “may represent a significant pathway to nonmedical opioid use among adolescents.” In fact, compared to a control group of non-drug-using, non-operative 13-to-21-year-olds, the surgery group averaged 50 times more likely to become habitual opioid users after discharge from hospital. Recent studies have demonstrated that postoperative use of opioids presents an important risk factor for new opioid dependence, said Calista Harbaugh, MD, of the University of Michigan. This first-of-its-kind study investigated new opioid use among “opioid-naïve” adolescents after surgery. From 2010 to 2015, the surgical cohort of 88,637 young patients underwent one of 13 common surgeries. None had any history of prior opioid prescriptions.

The surgical patients were a mean age of 17 years, and the incidence of new, persistent opioid use following surgery was 5 percent, compared to only 0.1 percent among the non-operative control group. Continued opioid use ranged from 2.7 percent to 15.2 percent across the different surgeries, yielding a mathematical range of increased risks of from 27 times to 152 times, depending on the surgical procedure. Surgeries associated with the highest risk of new opioid use were cholecystectomy – removal of the gall bladder – and colectomy – removal of part of or the entire colon. Other risk factors independently associated with new persistent opioid use included older age, being a girl, higher comorbidity, anxiety, and pre-existing drug and substance use. “Identifying alternative methods of perioperative pain management for this population should be a priority,” Harbaugh concluded.

More kids in ER for opioids

In a related study, researchers at the University of Iowa have expanded the current national estimates of opioid abuse by children and adolescents. The study has found a significant increase during the period from 2008 to 2013 in the number of emergency department (ED) visits by children for opioid abuse or dependence. The number of ED visits that included codes for opioid abuse or dependence rose from over 33,000 visits in 2008 to nearly 50,000 in 2013. Veerajalandhar Allareddy, MD, and colleagues at the Stead Family Children's Hospital in Iowa City, said, “We sought to estimate the burden of opioid dependence/abuse (OD/OA) in children who visited the emergency department for any cause in the United States.” The study found 250,000 ED visits across the country among children up to age 21 for opioid abuse or dependence. Nearly 90 percent of the visits were by patients ages 18 to 21 years old, with only 8 percent among those aged 16 to 17 years. More than half – 56 percent – were boys. Some 200 kids died in EDs, and 325 died following hospitalization. The most common diagnostic codes were “Unspecified” opioid abuse and opioid dependence. The study also looked at the average costs of the ER and hospitalization admissions for the study period. Mean ED charges were roughly $2,300, totaling $505 million. Hospitalization costs were over $23,000, totaling $2 billion. Younger patients, defined as 9 or under, and patients with heavy comorbidities, as well as those from higher income households, were “more likely to be hospitalized as opposed to being routinely discharged from the ED. The uninsured were less likely to be hospitalized,” the study said. If you or someone you know has adolescent children who might be exposed to drugs, take the time to help get some dialog going with them about the dangers kids are facing today. And if you or someone you care about has a substance use problem, don’t hesitate to call Novus right away.

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