Abstract
ObjectivesOur first goal is to evaluate the prevalence of hospital admissions for prescription opioid overdose (POD) in pediatric inpatients, and next goal is to measure the independent association between cannabis use disorders (CUD) and POD.MethodsWe used the nationwide inpatient sample (NIS) and included 27,444,239 pediatric inpatients (age ≤ 18 years), and 10,562 (0.04%) were managed primarily for POD. The odds ratio (OR) of the association of variables in POD inpatients was measured using the binomial logistic regression model that was adjusted for demographic confounders and psychiatric comorbidities.ResultsAdolescents have higher odds (OR 10.75, 95% CI 10.16-11.36) of POD-related hospitalization compared to children ≤ 12 years. Whites formed the significant proportion (67%), and those from low-income families (<50th percentile) had higher likelihood for POD-related hospitalization. The most prevalent psychiatric comorbidities were mood disorders (44.3%) and anxiety disorders (14.6%). Prevalent comorbid substance use disorders (SUDs) included cannabis (14.2%), tobacco (13.1%), and opioid (9.4%). A higher odds of association with POD-related hospitalizations were seen in pediatric inpatients with comorbid opioid (OR 8.79, 95% CI 8.08-9.56), tobacco (OR 1.58, 95% CI 1.47-1.70), and cannabis (OR 1.68, 95% CI 1.57-1.81) use disorders.ConclusionThe prescription opioid is a bridge to opioid abuse/dependence, thereby increasing the risk of other SUDs like tobacco (by 58%) and cannabis (by 68%). Regulating the easy availability of prescription opioids and also improving the existing prescription trends are an essential way to reduce this problem. Finally, awareness and counseling are recommended strategies for harm reduction/rehabilitation among the pediatric population.
Highlights
A widespread emphasis and discussion over adequate assessment and treatment of pain in children are, over the past decade, resulting in a surge in the prescription of opioids in pediatric emergency departments (ED)
Our first goal is to evaluate the prevalence of hospital admissions for prescription opioid overdose (POD) in pediatric inpatients, and goal is to measure the independent association between cannabis use disorders (CUD) and POD
Adolescents have higher odds of POD-related hospitalization compared to children ≤ 12 years
Summary
A widespread emphasis and discussion over adequate assessment and treatment of pain in children are, over the past decade, resulting in a surge in the prescription of opioids in pediatric emergency departments (ED). The opioid prescription seems to be influenced by factors like race, gender, and insurance This trend mimics the adult population in terms that black patients seem to receive fewer opioid prescriptions, a trend which may be attributed to lack of access to medical care and medications due to cost and lesser availability of pharmacy [3,4]. There is an increased tendency to prescribe opioids in patients on private insurance, How to cite this article Pankaj A, Oraka K, Caraballo-Rivera E J, et al (October 20, 2020) Recreational Cannabis Use and Risk of Prescription Opioid Overdose: Insights from Pediatric Inpatients. Though pain assessment and relief are of utmost importance in the pediatric population, studies have shown that inadequate pain relief in this age group can have a worse prognosis, and making easier availability of opioids can lead to accidental prescription opioid overdoses, poisoning, and misuse, which should be given greater attention [6,7]
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