Saving Kids From Addiction: Shriners Children’s Sets Standards for Adolescent Opioid Use Post-Surgery

Opioids are powerful pain relievers commonly prescribed to high school athletes recovering from sports injuries. The goal for their use is to reduce pain and speed recovery. However, opioids are also highly addictive, and the amount prescribed for common surgical procedures varies significantly depending on the provider.

Too Many Pills, Too Little Data

“There are so many kids – football players, cheerleaders, baseball and volleyball players – excelling at various activities. They play hard, they get injured, they need surgery, and they're given opioids to manage pain,” said Sundeep (Sunny) Tumber, D.O., chief of pediatric anesthesia at Shriners Children’s Northern California.

“We hear these stories over and over again. Some kids receive too many pills, get hooked, and it becomes a near life sentence for them and their families,” Dr. Tumber added. “We have to break this cycle.”

While there are benefits for the use of appropriate opioid pain medicines, there are also risks. Opioids can cause serious side effects and lead to dependence, addiction and overdose. A nationwide survey commissioned by the American Society of Anesthesiologists found that while more than half of parents surveyed expressed concern their child may be at risk for opioid addiction, nearly two-thirds believe opioids are more effective at managing their child’s pain after surgery or a broken bone than non-prescription medication or other alternatives.

In 2018, over 10% of U.S. adolescents were prescribed opioids, most commonly for injuries, dental work or surgery, according to a report by the Centers for Disease Control and Prevention. A 2021 report released by the American Academy of Pediatrics highlighted the lack of national data on details about opioid prescriptions for children, adolescents and young adults.

Collaborating to Set Industry Standards

Recognizing the need for data to guide safe and effective opioid use in adolescent pain management, Dr. Tumber and colleagues from 10 other facilities within Shriners Children’s international healthcare system are conducting a comprehensive, three-year study. The goal is to standardize and optimize pain management protocols for opioid use after ACL surgery in adolescents and young adults.

“Establishing detailed protocols will ensure all staff are comfortable with pain management plans related to ACL surgery. This will reduce variability, improve patient safety and support evidence-based care,” said Lloyd Halpern, M.D., pediatric anesthesiologist at Shriners Children’s Spokane, another of the Shriners Children’s physicians participating in the study.

“Shriners Children’s is the largest provider of pediatric orthopedic healthcare in the world,” Dr. Tumber said. “We’re in a unique position to collaborate and develop protocols that will improve outcomes for our own patients, and that will also save countless young lives by shaping industry-wide best practices.

“Extra prescription opioids are a major source of misuse among high school students,” Dr. Tumber continued. “We want to ensure young patients aren’t in pain, but we also know that less exposure to opioids is better. This research is about finding that delicate balance.”