TOPLINE:

Opioid prescriptions for children and adolescents aged 19 years or younger decreased from 2018 to 2022. Dentists and surgical subspecialists were the top prescribers, whereas pediatricians showed an approximately 56% reduction in opioid prescriptions.

METHODOLOGY:

• Researchers analyzed nationally representative pharmaceutical claims data, covering most US retail pharmacy prescriptions from 2018 to 2022.
• The study included opioid prescriptions dispensed to children and adolescents aged 19 years or younger; data were stratified by age: 0-2, 3-9, and 10-19 years.
• Over 14 million opioid prescriptions were analyzed, with annual dispensing rates calculated per 1000 youth using US Census data.
• Trends of opioid dispensing were examined by age, sex, prescriber specialty, type of opioid, and duration of action.

TAKEAWAY:

• Annual rates of opioid dispensing for US youth decreased by 35.5% from 46.9 to 30.2 prescriptions per 1000 youth between 2018 and 2022. Short-acting opioids accounted for 99.4% of prescriptions.
• More than 88% of opioids were dispensed to children and adolescents aged 10-19 years, with a rate 5.4 times higher than that for children aged 3-9 years. Dispensing rates were comparable for men and women at 34.6 and 37.0 per 1000 youth, respectively.
• Dentists and surgical subspecialists were the top prescribers, with their prescriptions accounting for 34.8% and 23.7% of prescriptions, respectively. Pediatricians prescribed only 1.9% of opioids and saw the largest reduction in prescriptions (56.4%) during the study period.
• The share of codeine and tramadol dispensed saw the largest decrease among the opioids assessed in the study.

IN PRACTICE:

“Implementation of validated assessment tools to identify youth with substance use and mental health disorders whose opioid use might carry higher risk, as well as educating clinicians and patients on appropriate opioid use, could improve understanding of opioid prescribing,” the authors wrote. “Opioid overdose prevention efforts, evolving clinical practice guidance, and attention to safer prescribing recommendations might have contributed to decreases in opioid dispensing,” they added.

SOURCE:

The study was led by Ceciley Bly, DO, MPH, of the Division of Overdose Prevention at the National Center for Injury Prevention and Control, CDC, Atlanta, Georgia. It was published online on October 9, 2025, in Journal of Adolescent Health.

LIMITATIONS:

Prescriptions that were written but not dispensed or the actual use of opioids after being dispensed were not included. Clinical information, diagnoses, and prescription-related factors such as total daily dosage or number of pills given were unavailable. 

DISCLOSURES:

The authors reported no outside funding sources for this work. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.