Recognition and Management of Iatrogenically Induced Opioid Dependence and Withdrawal in Children: Clinical Report
Opioids are often prescribed to children for pain relief related to procedures, acute injuries, and chronic conditions. Around-the-clock dosing of opioids can produce physiologic opioid dependence within 5 days. According to a 2001 consensus paper from the American Academy of Pain Medicine, American Pain Society, and American Society of Addiction Medicine, dependence is defined as "a state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, or administration of an antagonist." The experience of children undergoing iatrogenic withdrawal symptoms is variable and may be mild and go unreported or can be severe and even life threatening. Guidance on opioid withdrawal is available only for adults and primarily for adults with substance use disorders. This report will summarize existing literature and provide readers with information on how to screen for symptoms of iatrogenic opioid withdrawal as well as mechanisms for opioid withdrawal prevention.
Authors
- J. Routt Reigart
- Elizabeth T. Drum (ORCID: https://orcid.org/0000-0003-1943-3060)
- Jennifer L. Goldman (ORCID: https://orcid.org/0000-0001-6628-8949)
- Adam C. Adler (ORCID: https://orcid.org/0000-0002-6518-1549)
- Philip A. Verhoef (ORCID: https://orcid.org/0000-0002-1502-5468)
- Vijay Srinivasan (ORCID: https://orcid.org/0000-0001-8259-3337)
- Benson Hsu
- Kevin Watt (ORCID: https://orcid.org/0000-0002-5975-5091)
- Mary Landrigan‐Ossar
- Christina Diaz
- Julie Good (ORCID: https://orcid.org/0000-0002-6064-0937)
- Margaret A. Satchell
- Debnath Chatterjee (ORCID: https://orcid.org/0000-0002-4447-1790)
- Lena S. Sun (ORCID: https://orcid.org/0000-0002-1100-8492)
- Jimmy W. Huh (ORCID: https://orcid.org/0000-0003-4268-4829)
- Justin Long (ORCID: https://orcid.org/0000-0002-7660-6063)
- Lia Lowrie
- Olive S. Eckstein (ORCID: https://orcid.org/0000-0002-1895-8810)
- Brittany L. Willer (ORCID: https://orcid.org/0000-0002-4123-6867)
- Robert T. Wilder (ORCID: https://orcid.org/0000-0002-8343-3607)
- Linda Siegel
- Simon-Noel Ndely
- Diane E. Hindman
Institutions
- Mayo Clinic (US)
- Stanford Health Care (US)
- Cohen Children's Medical Center (US)
- Mayo Clinic in Arizona (US)
- North Shore Diabetes and Endocrine Associates (US)
- Stanford Medicine (US)
- Mayo Clinic in Florida (US)
- Texas Children's Hospital (US)
- Stanford University (US)
Publication Details
- Journal
- PEDIATRICS
- Published
- 2025-08-18
- DOI
- https://doi.org/10.1542/peds.2025-073169
- Primary Topic
- Pediatric Pain Management Techniques
- Type
- article
- Field-Weighted Citation Impact
- 0.00