In healthcare, the increased use of prescription opioid medications (pain medicines like codeine) has lead to a number of concerns including increased accidental ingestion by toddlers and young children, increase in non-medical uses of opioid drugs, and an increase in the use of non-prescription opioids (such as heroin) by people who become dependent on prescription medications.
The increase in prescription pain medications began back in the 1990’s when concerns arose that we (US medical providers) were not adequately treating pain. Asking patients if they had any pain when they checked in for medical visits became the ‘5th vital sign’ in addition to checking height, weight, blood pressure, and heart rate. While asking about and addressing pain is very important, there was an unintended consequence of increased prescribing of pain medications.Prescription opioids include medications like codeine, hydrocodone, oxycodone, hydromorphone, and fentanyl. These medications are often used after medical procedures or for patients undergoing painful treatment.
In the journal Pediatrics, the April 2017 volume has a number of research articles that look at how exposure to prescription opioids is affecting children and teens. One article describes how there were over 188,000 calls to poison control centers from 2000-2015 for children under age 20. Amongst those, teens were more likely to require admission to a health care facility or have serious medical outcomes related to their exposure when compared to younger children. The suspected suicides amongst teenagers related to prescription opioids also increased by nearly 53% during this 15 year period.
A separate study examined use of prescription and non-medical use of prescription opioids among high school students over a time period from 1979-2015. Prescription opioid use increased until the early 2000’s and since 2013 has been declining. However, they noted differences in which teens are using these drugs. While females were more likely to use medications prescribed specifically to them, males were more likely to use prescription medications that were not prescribed to them. White teens were more likely to be given prescription pain medications than black teens.
So what should parents make of all of this?
- Prescription pain medications can be dangerous. Taking too much can lead to decreased effort to breath and other medical complications that can require hospitalization and even lead to death.
- The increase in prescription opioid coincided with the increase in non-prescription drugs (such as heroin). These medications can lead to addiction. No one should take a medication that isn’t being prescribed specifically to them by a healthcare provider.
- If your teen has a procedure, ask if an opioid pain medication is necessary. Often we can provide other options (such as NSAIDs) or we can limit the number of doses given in order to minimize risk.
- Remove unused prescription medications from the home. If no one is using the medicine, ask your pharmacy or local fire station if they offer a drug take back program.