Citations 2
Recognition and Management of Iatrogenically Induced Opioid Dependence and Withdrawal in Children: Clinical Report
Siegel, Linda, Wilder, Robert T. , Good, Julie , Reigart, J. Routt, Eckstein, Olive S. , Hindman, Diane E., Verhoef, Philip A. , Watt, Kevin , Care, Section on Critical, Hsu, Benson, Huh, Jimmy W. , Lowrie, Lia, Ndely, Simon-Noel, Satchell, Margaret A., Medicine, Section on Anesthesiology and Pain, Chatterjee, Debnath , Diaz, Christina, Drum, Elizabeth T. , Sun, Lena S. , Willer, Brittany L. , Landrigan‐Ossar, Mary, Adler, Adam C. , Goldman, Jennifer L. , Hindman, Diane E., Care, Section on Critical, Ndely, Simon-Noel, Srinivasan, Vijay , Medicine, Section on Anesthesiology and Pain, Long, Justin B.
Pediatrics | August 18, 2025 | Volume: 156 | Issue: 3 | Pages: No page available
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.
Oral Health Care for Children and Youth With Developmental Disabilities: Clinical Report
Sarvas, Elise , Webb, Jessica , Landrigan‐Ossar, Mary, Yin, Larry , HEALTH, SECTION ON ORAL, Beyer, Eric L., Brooks, Chevon, Feldman, Lauren , Kimball, C E, Tate, Anupama Rao , Unkel, John H. , Zaborowski, Matt, Crespin, Matt, Moursi, Amr M. , Beskin, Kera , Agrawal, Rishi , Bell, Deanna S. , Foster, Jessica E.A., Fremion, Ellen , Frierson, Sheryl, Melicosta, Michelle, Saunders, Barbara S. , Srivastava, Siddharth , Vargus‐Adams, Jilda , Kuo, Dennis Z. , Brosco, Jeffrey P. , Sadof, Matthew , Ware, Allysa , Yeargin-Allsopp, Marshalyn, Poon, Jennifer, Yeargin-Allsopp, Marshalyn, Kuznetsov, Alexandra , MEDICINE, SECTION ON ANESTHESIOLOGY AND PAIN, Chatterjee, Debnath , Diaz, Christina D. , Drum, Elizabeth T. , Sun, Lena S. , Willer, Brittany L. , Landrigan-Ossar, Mary, Fehr, James J. , Lin, Yuan‐Chi, Riefe, Jennifer, Sarvas, Elise W , HEALTH, SECTION ON ORAL, Karp, Jeffrey M. , Kimball, C. Eve, Sokal‐Gutierrez, Karen , Noritz, Garey H. , Zuckerman, Katharine E. , Weitzman, Carol Cohen , Yeargin-Allsopp, Marshalyn, Yeargin-Allsopp, Marshalyn, MEDICINE, SECTION ON ANESTHESIOLOGY AND PAIN, Long, Justin, Landrigan-Ossar, Mary, Adler, Adam C.
Pediatrics | July 22, 2024 | Volume: 154 | Issue: 2 | Pages: No page available
Oral health is an essential component of overall health for all individuals. The oral health of children and youth with developmental disabilities (CYDD) involves unique characteristics and needs of which pediatricians and pediatric clinicians can be aware. Risk for oral disease in CYDD is multifactorial and includes underlying medical conditions, medications, and ability to participate in preventive oral health care and treatment, and lack of access to providers is common for this population despite being eligible for Medicaid. Pediatric clinicians are uniquely positioned to support the oral health needs of CYDD and their families through the medical home. This clinical report aims to inform pediatric clinicians about the unique oral health needs of CYDD. It provides guidance on assessing caries risk and periodontal status using structured screening instruments; understanding dental trauma, the role of diet and caries risk, trauma prevention, and malocclusion; and providing anticipatory guidance on oral hygiene that includes tooth brushing, use of fluoridated toothpaste, assessing community water fluoridation, advocating for a dental home by 1 year of age, and transition to adult dental care as part of adolescent health care. It also highlights special considerations for dental treatment rendered under sedation or general anesthesia that CYDD may need. Pediatric clinicians can help reduce risk of CYDD developing dental disease by understanding the unique needs of their patients and their barriers to accessing oral health care in their community, communicating with the child’s dental home, and advocating for safe and accessible dental procedures.