Guidance released for tapering of opioids to prevent withdrawal in children

A plan for tapering opioids must be developed to attenuate withdrawal signs in kids receiving opioids for 5 or extra days, based on a medical report from the American Academy of Pediatrics (AAP) published on-line Aug. 18 in Pediatrics.

Adam C. Adler, M.D., from Texas Kids’s Hospital in Houston, and colleagues deal with screening for signs of iatrogenic opioid withdrawal in addition to mechanisms for opioid withdrawal prevention.

The authors observe that the indicators and signs related to withdrawal within the pediatric inhabitants are comparatively constant, with the first manifestation usually being neuropsychiatric signs. Generally seen physiologic adjustments embrace elevated muscle tone, nausea, vomiting, and diarrhea.

Withdrawal signs could be skilled with opioid administration of 5 or extra days; suppliers ought to take into account preemptively tapering opioids if prescribing opioids for 5 or extra days. A plan to taper the opioid whereas minimizing withdrawal signs must be developed; the plan ought to embrace affected person help construction and be guided by the affected person’s main care doctor.

Behavioral remedy could also be a helpful a part of any weaning program. For sufferers with ongoing analgesia wants, nonopioid analgesics could be helpful and might scale back opioid necessities. Bodily or occupational therapy ought to kind a part of the therapy plan.

Widespread pitfalls in tapering opioids embrace a schedule that’s too speedy, failure to reassess and individualize the schedule, or inadequately accounting for analgesic wants. Weaning could be difficult by nonrecognition of withdrawal signs or attribution of unrelated signs to withdrawal.

“Prescription opioid use is prevalent in each pediatric inpatient and outpatient settings. Abrupt discontinuation of opioids can result in drug-specific withdrawal signs,” the authors write. “For sufferers receiving extended opioid remedy (greater than 5 days), it’s best to develop a plan to taper the opioid remedy whereas minimizing withdrawal symptoms.”

© 2025 HealthDay. All rights reserved.