OBJECTIVES: Abuse of opioids among children and adolescents has become a major public concern. Understanding the epidemiology of opioid use in this vulnerable population is critical to address opioid abuse. This study aimed to characterize patterns of opioid use for treatment of acute pain (such as postoperative pain of tonsillectomy and/or adenoidectomy, burns, and common acute non-cancer pain) among children and adolescents enrolled in Mississippi Medicaid.

METHODS: A retrospective cohort study was conducted using the Mississippi Medicaid data from July 2015 through December 2017. The proportion of children and adolescents less than 21 years of age using opioids within seven days following any qualifying acute pain episode was examined. Dose, duration, and type of opioid therapy were recorded in each case. A three-month washout period prior to the prescription index date was used to identify presence of mental health disorders, obstructive sleep apnea, and other comorbidities. Bivariate analyses were used to test differences in opioid use characteristics among various demographic variables and preexisting clinical characteristics.

RESULTS: A total of 164,787 beneficiaries with a qualifying acute pain episode were included in the study. Of these, 8,448 (5.1%) received an opioid prescription within seven days following an acute pain episode. Beneficiaries between the ages of 18 and 21, caucasians, and males were more likely to receive opioids. The majority received Schedule II or III-IV short-acting opioids. There was no significant association between the use of opioids for acute pain and the presence of MH disorders.

CONCLUSIONS: The results provide evidence that can help develop strategies for encouraging appropriate use of opioids following acute pain among children and adolescents. Further studies are needed to investigate the influence of clinical risk factors such as mental health disorders and obstructive sleep apnea on the prescription of opioids for treatment of acute pain in this population.