Peer-reviewed article
The Pediatric Opioid Overdose and Addiction Crisis.
Kronish A, Hadland SE, Calihan JB ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001Youth opioid overdose deaths in the United States have more than doubled since 2019, and overdose is now the third leading cause of death among US children and adolescents. The crisis is driven by an unpredictable drug supply contaminated with fentanyl. Pediatricians can help by screening for early use, providing evidence-based treatment, reducing harm, and engaging families, but many lack sufficient training. This review covers prevention, screening, diagnosis, and management of youth opioid use disorder including medication and behavioral treatments.
Key points
- Youth opioid overdose deaths more than doubled since 2019
- Overdose is now the third leading cause of death among US children and adolescents
- Fentanyl contamination makes the drug supply unpredictable and hazardous
- Pediatricians lack sufficient training and experience to provide opioid use disorder care
- Evidence-based prevention, screening, treatment, and harm reduction strategies exist but are underutilized
Limitations
This is a review article rather than an original study, so it synthesizes existing evidence but does not present new data on the effectiveness of specific interventions. It does not provide quantified estimates of the prevalence of youth opioid use disorder or detailed outcome data from individual trials.
Abstract
Adolescent and young adult (hereafter, "youth") experimentation with pills and powders is increasingly risky due to an unpredictable and hazardous drug supply characterized by fentanyl contamination. Youth opioid overdose deaths have more than doubled since 2019, and overdose is now the third leading cause of death among US children and adolescents. Pediatricians have an opportunity to improve outcomes for youth who use opioids by addressing risk factors for problematic opioid use, recognizing early use, providing evidence-based treatment, educating on strategies to reduce harm and overdose, and engaging family and communities to support recovery and well-being. Yet pediatricians with insufficient training and/or experience may feel unprepared to provide this care. This review provides a detailed overview of youth opioid use disorder prevention, screening, diagnosis, and management with an emphasis on pharmacotherapy and behavioral treatments, frameworks to support engagement in care, and emerging strategies to prevent opioid-related harms, including overdose.