Opioid-prescribing Patterns for Pediatric Patients in the United States
Opioid-prescribing Patterns for Pediatric Patients in the United States
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DOI：
10.1097/ajp.0000000000000707
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发表时间：
2019-06-01
影响因子：
2.9
通讯作者：
Groenewald, Cornelius B.
中科院分区：
文献类型：
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作者：
Groenewald, Cornelius B.
背景和目标：美国的阿片类药物危机影响成人和儿童。然而，关于阿片类药物危机的流行病学，阿片类药物处方模式以及阿片类药物处方与问题阿片类药物行为之间的联系的知识仍然有限。因此，儿童往往被排除在旨在遏制阿片类药物危机的卫生保健政策和指导方针之外。这篇专题综述的主要目的是简要概述影响儿童的阿片类药物危机，然后简要介绍最近关于阿片类药物处方模式的研究，以及关于合法阿片类药物使用与有问题的阿片类药物使用行为风险之间联系的数据。方法：这是一个叙述性综述。结果如下：阿片类药物滥用是美国儿童和青少年面临的公共卫生危机，也是其他问题阿片类药物行为的关键前提，包括阿片类药物使用障碍，海洛因使用和阿片类药物过量。此外，与2000年之前的处方率相比，美国儿童和青少年类阿片处方量大幅增加。然而，关于阿片类药物处方模式与阿片类药物使用问题风险之间关系的数据仍然有限。讨论内容：目前迫切需要确定青少年在接受医学处方阿片类药物后出现阿片类药物使用行为问题的风险增加。文章最后给出了一些一般性指南，供应商可以遵循这些指南来降低儿科患者使用阿片类药物的风险。
Background and Objectives: The opioid crisis in America affects both adults and children. However, knowledge about the epidemiology of the opioid crisis, opioid prescribing patterns, and the link between opioid prescribing and problematic opioid behaviors remain limited. Thus, children are often excluded from health care policies and guidelines aimed at curbing the opioid crises. The primary aim of this topical review is to provide a brief overview of the opioid crises affecting children, followed by a synopsis of recent research on opioid prescribing patterns and data on the links between legitimate opioid use and risk for problematic opioid use behaviors. Methods: This is a narrative review. Results: Opioid misuse is a public health crisis facing children and adolescents in the United States and serves as a key antecedent for other problematic opioid behaviors, including opioid use disorder, heroin use, and opioid overdose. Furthermore, the United States experienced a significant increase in opioid prescribing to children and adolescents as compared with prescribing rates before the year 2000. Yet, data on the associations between opioid prescribing patterns and risk for problematic opioid use remains limited. Discussion: There exist an urgent need to identify adolescents at increased risk for problematic opioid use behaviors following a receipt of medically prescribed opioids. The article closes with some general guidelines that providers may follow to reduce the risk of opioids in pediatric patients.