Hospital ERs prescribe fewer opioids to some children, but not others

There’s some good news on the opioid front lines.

A recent study of 69,152 emergency department visits by patients under 18 concluded that opioid prescribing rates to treat pain decreased to 6.3% of those patients between 2011 and 2015 from 8.23% during 2006 to 2010. However, the location of the ER department, race, age and payment method were associated with differences in opioid prescribing, the study released this month found.

Opioid prescribing rates for pediatric patients were higher in the western U.S. White patients and patients aged 13 to 17 were more likely to receive prescriptions, for example, while patients using Medicaid were less likely to get opioid prescriptions. The researchers, who published their findings in the JAMA Open Network, said “inconsistencies” in opioid-prescribing required further research.

White patients and patients aged 13 to 17 were more likely to receive prescriptions, while patients using Medicaid were less likely to get opioid prescriptions.

“The use of opioids to treat pain in pediatric patients has been viewed as necessary,” the study noted. “However, this practice has raised concerns regarding opioid abuse and the effects of opioid use. To effectively adjust policy regarding opioids in the pediatric population, prescribing patterns must be better understood.” Some estimates put the national cost of the epidemic at $500 billion.

In separate research that included all doctors, prescription opioids dispensed by medical professionals to children and adolescents have been cut in half since 2012, according to a recent analysis of data from a large commercial insurance provider and published in the JAMA Pediatrics, a monthly peer-reviewed medical journal published by the American Medical Association.

At the start of 2017, an average of two out of every 1,000 children and adolescents received an outpatient opioid prescription in any given month, the study said. In 2004, three out of every 1,000 children and adolescents were prescribed opioids. That rose to four per 1,000 between 2009 to 2012. There was also a drop in the long-term opioid prescription use (three or more consecutive months).

Also see: This state’s largest insurer cuts coverage for OxyContin

Still, this reflects a more dramatic decrease than the overall downward trend. The opioid prescribing rate has fallen to the lowest in more than 10 years at 58.7 prescriptions per 100 persons (equivalent to 191 million prescriptions). The total number of prescriptions dispensed peaked in 2012, totaling more than 255 million, and a prescribing rate of 81.3 prescriptions per 100 persons.

At the start of 2017, two out of every 1,000 children and adolescents received an outpatient opioid prescription in any given month, down from four per 1,000 between 2009 and 2012.

Prescription rates vary dramatically, however. “In 2017, prescribing rates continue to remain very high in certain areas across the country,” according to the Centers for Disease Control and Prevention. While the overall opioid prescribing rate reached the lowest rate in a decade last year, “some counties had rates that were seven times higher than that.”

An estimated 2.1 million people in the U.S. are battling opioid addiction. Since 2010, the number of opioid overdose deaths doubled to 42,000 in 2016, according to the U.S. Department of Health and Human Services. The rate of drug overdose deaths in the U.S. in 2015 was more than 2.5 times the rate in 1999, partly due to a fall in the price of heroin and accessibility to prescription drugs.

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