Blog | Monday, March 10, 2014

QD: News Every Day--Teens with headaches prescribed opioids, against guidelines

Nearly half of teens with headaches received an opioid during follow-up treatments, and more than one-quarter of that group got 3 or more, despite guidelines against opioids as a first-line treatment, a study found.

Researchers reported results as an article in press in the Journal of Adolescent Health.

Among teens using opioids, within the first year of treatment, 47.8% received 1 prescription, 22.5% received 2, and 29.3% received 3 or more. Of those with opioid prescriptions, 25% had a migraine diagnosis at index date, and 28% had an ED visit for headache during follow-up compared to 14% who did not get opioids (P<0.01). ED visits with a headache diagnosis during follow-up more than doubled opioid use (odds ratio, 2.02; 95% CI, 1.79 to 2.29).

Adolescents who received opioids also received more CT scans (35.6% with opioids vs. 25.6% without, P<0.01) and lumbar punctures (4.2% with opioids vs. 1.2% without, (P<0.01) than teens who did not receive opioids, likely due to the association with ED visits, researchers wrote.

“A definitive conclusion cannot be drawn as to whether the correlation between ED visits and opioid prescription was due to headache severity at presentation or due to practice patterns. However, we believe practice patterns to be the driving factor based on a recent study demonstrating a greater likelihood of neuroimaging to diagnose pediatric headache in the ED despite a normal history,” the researchers wrote.