The American Academy of Pediatrics (AAP) released its first on prescribing opioids for outpatient acute pain management to youth. Although it cautions against the dangers of rising opioid use disorder among children and teens, it also notes that a decrease in opioid prescription rates may leave some youth with pain that is not adequately treated.

鈥淭here鈥檚 been a big pendulum swing in the practice of medicine over the last two decades鈥攆irst with opioid-overprescribing, then with a huge cutback in opioid prescribing,鈥� Scott Hadland, MD, MPH, the lead author of the guideline, said in a . 鈥淲e want pediatricians to prescribe opioids when they鈥檙e needed because untreated pain can lead to distress and psychological harm.鈥�

The guideline鈥攚hich is based on evidence from randomized clinical trials, observational studies, and expert opinion鈥攊ncludes steps pediatricians should take when prescribing opioids to reduce the long-term risk of addiction. It also recommends a routine prescription for the overdose-reversal medication naloxone with every opioid order.

Additionally, the guideline recommends that pediatricians should prescribe opioids in conjunction with nonopioid medications, such as ibuprofen, and nonpharmacological approaches for pain reduction, such as physical therapy. It also notes that American Indian and Alaskan Native, Black, and Hispanic individuals are often less likely to receive timely treatment, and stresses the importance of equitable access to effective pain management, with or without opioids.

Published Online: October 25, 2024. doi:10.1001/jama.2024.21821