Untreated pain in childhood may have ramifications well into adulthood. Opioid medications have an important role in care for moderate to severe pain that cannot be relieved by first-line interventions, but clinicians must approach opioid use in the emergency department in an evidence-based, socially responsible manner. This issue reviews evidence-based approaches to assessment and management of pain in children and adolescents, with a focus on optimizing nonopioid pain management as a first approach and using opioid medications safely, when appropriate. Recommendations are provided for safer opioid prescribing, including assessment of risk factors for opioid misuse, careful family counseling and education, and suggested prescribing limits. Prescription and use of naloxone in the emergency department and as take-home kits are also discussed.
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Table 3. Screening Tools for Substance Use in Adolescents
|Screening to Brief Intervention* (S2BI)||
|Brief Screener for Tobacco, Alcohol, and other Drugs* (BSTAD)||
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Following are the most informative references cited in this paper, as determined by the authors.
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Keywords: opioids, opioid medications, pain management, nonopioid pain management, opioid misuse, opioid use disorder, ibuprofen, naloxone, analgesia, pain measurement tools, pain scale, pain assessment, physical pain management, psychological pain management, pharmacologic pain management, nonsteroidal anti-inflammatory drugs, NSAID, oral opioids, intranasal opioids, intravenous opioids, opioid dosing, opioid dosage, adverse events, risk factors, risk assessment, safer opioid prescribing, prescription drug monitoring programs, screening tools for substance use, opioid prescribing limits
Samina Ali, MD, FRCPC; Amy L. Drendel, DO, MS
Deepa R. Camenga, MD, MHS, FAAP; Reuben J. Strayer, MD
January 1, 2023
January 1, 2026   CME Information
4 AMA PRA Category 1 Credits™, 4 ACEP Category I Credits, 4 AAP Prescribed Credits, 4 AOA Category 2-A or 2-B Credits. Included as part of the 4 credits, this CME activity is eligible for 4 Pain Management credits, 4 Controlled Substances credits, 4 Pharmacology credits, and 1 Addiction Disorders credit, subject to your state and institutional approval.