Last week I made a decision that could have altered the course of my child’s life. As my 13-year-old was waking up in the hospital recovery room from an outpatient procedure, I was offered the choice of giving her Tylenol or oxycodone for the pain. Really? Tylenol or oxycodone?
The choice was obvious to me. Tylenol. I’ll risk the possible liver damage if she overused that one. I won’t risk a lifetime of opioid addiction and a potential death from overdose from the other. It made me think: Why aren’t there better choices, something that’s more than Tylenol but not addictive like an opioid?
The American Academy of Pediatrics is also asking that question.
At its national conference happening right now, the American Academy of Pediatrics has been talking about opioid addiction and kids. Researchers presented the study “Adverse Effects from Opioid Use in Hospitalized Children in the United States: a 9-year trend from 2003 to 2012,” on Friday, and on Monday, “Opioid abuse in children: An emerging public health crisis,” is being presented.
There are two things going on here: Kids who are hospitalized become addicted to opioid painkillers because of their hospitalization and kids who come into the emergency room already have an addiction.
The first study looked at hospital stay records for kids ages 1 month to 17 years as reported in the Agency for Healthcare Research and Quality’s Healthcare Cost and Utilization Project Kids’ Inpatient Database.
“We found opioid-related problems were relatively common in hospitalized children,” said abstract author Dr. Jessica Barreto in a press release. For every 10,000 discharges during those years, 16.6 children left with opioid-related problems. And it’s on the rise, in 2003, it was 13.3 children by 2012, that grew to 20.8.
Opioid withdrawal problems affected 3.1 percent of the hospitalized children. They also had opioid-related constipation, altered mental status, urinary retention, cardiac arrest and anaphylaxis.
“For the past two decades, doctors have been increasingly recognizing and treating pain in children. Unfortunately, the efforts to improve pain management in children have led to a significant rise in the use of opioids both within hospitals as well as in the outpatient setting,” Barreto said, she’s a pediatric resident at at Nicklaus Children’s Hospital in Miami.
She’s recommending further study of pain and children as well as more options for less toxic pain medication for children.
That study found that the number of patients 21 and younger that tested positive for opioids rose from 32,235 in 2008 to 49,626 in 2013. “It was very concerning to see that by the last year we studied, an average of 135 children each day were testing positive for opioid addiction or dependency in emergency departments,” said Dr. Veerajalandhar Allareddy, one of the abstract’s authors and medical director of the pediatric intensive care unit at the University of Iowa Stead Family Children’s Hospital, in a press release. “In our opinion, this is a pediatric public health crisis,” he said.
One-third of those who tested positive were then admitted into the hospital, but this varied base on income level, with higher income level kids being more likely to be hospitalized for their addiction than their lower-income peers.