This article provides an overview of postoperative opioid prescribing, use, and disposal patterns in children and also identifies gaps in knowledge and areas for improvement. We present evidence that there is a need to tailor prescriptions to specific procedures to reduce the number of excess, unused prescription opioid pills in the home. We also explain the need to provide culturally competent care when managing a child’s pain after surgery. Finally, we discuss the need for widespread provider and caregiver education about safe prescription opioid use, storage, and disposal.
Opioids are frequently prescribed to children undergoing surgery, but most families report unused prescription opioid pills.
Providers must be aware of unconscious bias in pain management strategies when caring for minority children and families.
Education about safe prescription opioid storage and disposal should be provided to all families receiving opioids and coupled with easily available means of disposal.
Procedure-specific data about actual opioid consumption after discharge could help providers tailor their practices.
As the opioid epidemic continues in the United States, physicians are increasingly aware of their role in responsible opioid stewardship, defined as minimizing opioids prescribed while continuing to provide adequate analgesia. Most of the children who receive an opioid prescription after surgery only use a fraction of their prescription [
]. This can contribute to excess unused opioids in a child’s home, thereby increasing the risk of poisoning, accidental ingestion, and diversion to other family members or friends [ ]. There are increasing published guidelines and resources emerging to inform and engage providers in opioid stewardship efforts both during hospitalization and after discharge home [ ]. In this review, we will summarize current evidence regarding postoperative opioid prescription, use, storage, and disposal in children undergoing surgery and highlight gaps in knowledge requiring further study.