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Opioid withdrawal signs and symptoms in children: frequency and determinants

Deborah Fisher1, Mary Jo Grap, Janet B Younger

  • 1Division of Pediatric Palliative Care, Children's Hospital of Richmond at VCU, Virginia Commonwealth University Medical Center, 1250 East Marshall Street, Richmond, VA 23298, USA.

Heart & Lung : the Journal of Critical Care
|September 7, 2013
PubMed

Insights

Opioid withdrawal signs and symptoms were assessed in pediatric intensive care unit patients. While most children did not show daily withdrawal, common symptoms included diarrhea, vomiting, sweating, and fever.

Area of Science:

  • Pediatric Intensive Care
  • Pharmacology
  • Clinical Assessment

Background:

  • Opioids are frequently administered in pediatric intensive care units for pain management, sedation, and physiological support.
  • Children can develop physical dependence on opioids within 2-3 days of continuous therapy.
  • Opioid medications are gradually reduced when no longer medically necessary.

Purpose of the Study:

  • To determine the frequency of opioid withdrawal signs and symptoms in a pediatric population.
  • To identify factors associated with opioid withdrawal in children receiving opioid therapy.

Main Methods:

  • A prospective, descriptive study was conducted with 26 pediatric patients (2 weeks to 21 years) in a pediatric intensive care unit.
  • Patients received continuous or scheduled opioids for at least 5 days.
  • Data included opioid withdrawal scores (WAT-1), taper rates, opioid exposure duration, and patient age.

Main Results:

  • Only 45% of the 26 participants exhibited opioid withdrawal on any given day.
  • The Waters Opioid Withdrawal (WAT-1) scores showed limited variability.
  • The most frequently observed symptoms of opioid withdrawal were diarrhea, vomiting, sweating, and fever.

Conclusions:

  • Clinicians should utilize validated instruments like the WAT-1 for accurate assessment of opioid withdrawal in children.
  • Further research is necessary to identify specific risk factors for opioid withdrawal in pediatric patients.
Abstract

Keywords:
ChildCritical careOpioid analgesiaOpioid taperOpioid withdrawal

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