The Pediatric Opioid Overdose and Addiction Crisis

Abstract Adolescent and young adult (hereafter, “youth”) experimentation with pills and powders is increasingly risky due to an unpredictable and hazardous drug supply characterized by fentanyl contamination. Youth opioid overdose deaths have more than doubled since 2019, and overdose is now the third leading cause of death among US children and adolescents. Pediatricians have an opportunity to improve outcomes for youth who use opioids by addressing risk factors for problematic opioid use, recognizing early use, providing evidence-based treatment, educating on strategies to reduce harm and overdose, and engaging family and communities to support recovery and well-being. Yet pediatricians with insufficient training and/or experience may feel unprepared to provide this care. This review provides a detailed overview of youth opioid use disorder prevention, screening, diagnosis, and management with an emphasis on pharmacotherapy and behavioral treatments, frameworks to support engagement in care, and emerging strategies to prevent opioid-related harms, including overdose.