(HealthDay)—Almost half of pediatric opioid prescriptions are considered high-risk by one or more metric, and high-volume prescribers write more than half of the prescriptions, according to a study published online Aug. 16 in Pediatrics.

Kao-Ping Chua, M.D., Ph.D., from the University of Michigan in Ann Arbor, and colleagues identified opioid prescriptions dispensed to children and young adults (aged 0 to 21 years) in 2019 and calculated the proportion of U.S. children with one or more dispensed opioid prescription. Performance on six metrics of high-risk prescribing was calculated, and the proportion of prescriptions written by each specialty was examined. A total of 4,027,701 prescriptions were included in the analyses.

The researchers found that 3.5 percent of U.S. children and young adults had one or more dispensed opioid prescription. Overall, 41.8 of the prescriptions for opioid-naive patients exceeded a three-day supply and 3.8 percent exceeded a seven-day supply. For young children, 8.4 percent of prescriptions were for tramadol and 7.7 percent were for codeine. Daily dosages were ≥50 morphine milligram equivalents in 11.5 percent of prescriptions for adolescents and young adults; benzodiazepine overlap was reported in 4.6 percent. Almost half (45.6 percent) of the prescriptions were high-risk by one or more metric. Of the prescriptions, 61.4 percent were written by dentists and surgeons. High-volume prescribers wrote 53.3 and 53.1 percent of prescriptions and high-risk prescriptions, respectively.

“To improve the safety of pediatric opioid prescribing, initiatives targeting high-volume prescribers may be warranted,” the authors write.

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