A plan for tapering opioids needs to be developed to reduce withdrawal signs in youngsters receiving opioids for 5 or extra days, in accordance with a medical report from the American Academy of Pediatrics (AAP) printed on-line Aug. 18 in Pediatrics.
Adam C. Adler, M.D., from Texas Kids’s Hospital in Houston, and colleagues deal with screening for signs of iatrogenic opioid withdrawal in addition to mechanisms for opioid withdrawal prevention.
The authors observe that the indicators and signs related to withdrawal within the pediatric inhabitants are comparatively constant, with the first manifestation usually being neuropsychiatric signs. Generally seen physiologic adjustments embody elevated muscle tone, nausea, vomiting, and diarrhea.
Withdrawal signs might be skilled with opioid administration of 5 or extra days; suppliers ought to contemplate preemptively tapering opioids if prescribing opioids for 5 or extra days. A plan to taper the opioid whereas minimizing withdrawal signs needs to be developed; the plan ought to embody affected person help construction and be guided by the affected person’s main care doctor.
Behavioral remedy could also be a helpful a part of any weaning program. For sufferers with ongoing analgesia wants, nonopioid analgesics might be helpful and might scale back opioid necessities. Bodily or occupational remedy ought to kind a part of the remedy plan.
Widespread pitfalls in tapering opioids embody a schedule that’s too speedy, failure to reassess and individualize the schedule, or inadequately accounting for analgesic wants. Weaning might be difficult by nonrecognition of withdrawal signs or attribution of unrelated signs to withdrawal.
“Prescription opioid use is prevalent in both pediatric inpatient and outpatient settings. Abrupt discontinuation of opioids can lead to drug-specific withdrawal symptoms,” the authors write. “For patients receiving prolonged opioid therapy (more than five days), it is best to develop a plan to taper the opioid therapy while minimizing withdrawal symptoms.”
Extra info:
Adam C. Adler et al, Recognition and Administration of Iatrogenically Induced Opioid Dependence and Withdrawal in Kids: Medical Report, Pediatrics (2025). DOI: 10.1542/peds.2025-073169
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Steering launched for tapering of opioids to forestall withdrawal in youngsters (2025, August 19)
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