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Opioid Dispensing Trends Among Children and Adolescents Aged ≤ 19 Years in the United States: 2018-2022
Ceciley Bly1, Gery Guy2, Christina Mikosz2
1Division of Overdose Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia; Nazareth Hospital, Philadelphia, Pennsylvania.
Purpose:
Since 2019, adolescent overdose deaths have more than doubled, primarily due to illegally-made fentanyl. Prescription opioid misuse during adolescence increases the risk of substance use disorders and overdose. This analysis examines opioid dispensing trends among individuals aged ≤19 years to support safer prescribing practices.
Methods:
We used IQVIA National Prescription Audit New to Brand data (2018-2022), which includes 92% of US retail pharmacy prescriptions dispensed. Annual rates and percentage changes were calculated by sex, age, prescriber specialty, and product type.
Results:
From 2018 to 2022, opioid dispensing rates decreased 36% from 46.9 to 30.2 prescriptions per 1,000 youth. Declines were observed across all age groups (0-2 years, 59.2%; 3-9 years, 50.8%; 10-19 years, 34.4%) and dispense rates were similar by sex (males 34.6; females 37.0). Short-acting opioids comprised 99.4% of prescriptions and declined by 42.8%, compared to 27.3% for long-acting formulations. Dentists and surgical subspecialists accounted for the highest proportions of prescribing (34.8% and 23.7%, respectively), while pediatricians accounted for 2%, with a 56% reduction over the study period.
Discussion:
Opioid prescribing to children and adolescents ≤19 years declined substantially from 2018 to 2022, reflecting evolving clinical practice. Targeted outreach to high-prescribing specialties may further improve the safety of opioid use in acute pain management.
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