Opioid tapering in children: a review of the literature
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1Pediatric Palliative Care & Pain Management, Virginia Commonwealth University Medical Center, 1250 E Marshall St, Box 985841, Richmond, VA 23298, USA. dfisher@mcvh-vcu.edu
Purpose:
To synthesize and critically analyze literature related to pediatric opioid withdrawal.
Design:
Critical review of literature related to pediatric opioid tapering and withdrawal.
Methods:
Studies published in peer-reviewed journals were systematically searched using Cochrane, MEDLINE, CINAHL, and PsychINFO. Articles meeting the inclusion criteria were reviewed and analyzed for themes and similarities.
Findings:
The majority of published research has focused on the episodic nature of withdrawal symptoms during opioid tapering. Only 1 study produced a valid and reliable pediatric opioid withdrawal symptom assessment-instrument and 1 study produced a valid and reliable pediatric opioid and benzodiazepine symptom assessment instrument. One study conducted in an adult and pediatric population analyzed the effect of the use of an opioid taper algorithm on occurrence and nature of opioid withdrawal symptoms.
Conclusions:
The scope of research on pediatric opioid withdrawal is limited. Studies examining the effect of an opioid taper algorithm on incidence of withdrawal symptoms in children are sorely needed. Further validation of the 2 withdrawal assessment tools for children is warranted.
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