One in 10 Tennessee Children Prescribed Opioids for Non-Severe Conditions Over 15-Year Period, Study Finds

More than one in three Americans are prescribed opioids, National Survey on Drug Use and Health data shows. A new study indicates that the trend extended to children, who legally use the drug at as young as 2 years old, to treat pain following minor dental procedures or outpatient surgeries.

One in 10 children enrolled in Tennessee's Medicaid program were prescribed opioids between 1999 and 2014, concurrent with the onset of the opioid crisis, a study published in the journal Pediatrics found. Researchers argued that the drugs, all prescribed to children without severe conditions, caused "unnecessary exposure" to potential harm, and suggested that health care providers consider therapeutic options before prescribing the potent painkillers.

Over 15 years, Tennessee physicians prescribed more than 1.3 million opioids as pain relievers to children and teens between the ages of 2 and 17. While the Food and Drug Administration recommends opioids for minors with "severe conditions" such as cancer and sickle cell anemia, more than 30 percent of the drugs were prescribed after dental procedures in lieu of nonaddictive medications like ibuprofen.

For every 2,611 prescriptions a child was hospitalized, and more than 60 percent of those admissions were related to opioid-induced symptoms like bowel dysfunction and central nervous system depression, which can impede breathing.

While health agencies warn that children and teens find their parents' opioids and use them illicitly, these findings indicate that physicians prescribe them at higher rates even when chronic health conditions are absent, said Dr. Stephen Patrick, assistant professor of pediatrics and health policy at Vanderbilt University, who was not involved with the study.

"The study doesn't suggest patients demand opioids," Patrick told Newsweek. "The opioid epidemic is complex, it's complicated, it has patient- and physician-level origins. But I think what a study like this highlights is that opioids are not benign and should be used when they are appropriate for the shortest duration possible."

According to the Department of Health and Human Services, the hike in addiction rates began in the late 1990s, when health care providers began prescribing the pain-relieving drugs more frequently after the pharmaceutical industry claimed their use would not cause dependency.

Opioid addiction and misuse, which affected at least 11.5 million people in 2016, wasn't declared a public health emergency until 2017.

Half the patients prescribed opioids in the study were 12 to 17 years old, a group that's more likely to be hospitalized for substance abuse and attempted self-harm as a result of the drug. Addiction was more common among adolescents than younger children, Patrick said. As teens' brains develop, they tend to take more risks, likely due to the incipient nature of their frontal lobe, which manages inhibition and impulsive behavior.

Rural states such as Tennessee are "disproportionately affected" by opioid addiction, Patrick said. Prescription rates are higher in those states, but low economic opportunity and high unemployment can facilitate misuse and addiction. One-third of Tennesseans filled an opioid prescription between 2007 and 2011, and the Centers for Disease Control reported a 10 percent increase in opioid overdoses in Tennessee between 2015 and 2016. More rural areas fared worse: In West Virginia, physicians wrote 110 prescriptions per 100 people in 2013, according to the National Institute on Drug Abuse.

Nationwide rates of opioid prescriptions for minors didn't increase, but their exposure to the drug still rose as adult prescription rates did, a 2016 study found. Children and teens whose family members used prescription opioids were more likely to misuse or overdose from the drug, a clear spillover effect of legal pain relief.

"I think there's no question that we are prescribing far too many opioids in the United States," Patrick said.