Treatment of opioid use disorder
New guidelines can arm pediatricians with the basic understanding of treatment options to manage opioid dependence or addiction in children.
Although no singular guideline exists that specifically focuses on treatment of opioid dependence or addiction in children and adolescents, a recently published guideline by the American Society of Addiction Medicine (ASAM) on the use of medications to treat addiction involving opioid use includes a specific section on treatment for adolescents.5
This article summarizes key treatment strategies from the ASAM guideline. The aim of this article is not to provide a single approach or guideline on how to treat opioid dependence or addiction in children (as none yet exists), but to arm pediatricians with some basic understanding of treatment considerations as they either refer their patients to or collaborate with addiction specialists to provide the best treatment possible for their patients.
ASAM treatment guidelines
Published in 2015, the ASAM practice guideline focuses on the use of medications to treat addiction involving opioid use and provides a number of clinical recommendations based on 13 different areas (or parts).5 These areas include assessment and diagnosis; treatment options; treating opioid withdrawal; methadone; buprenorphine; naltrexone; psychosocial treatment in conjunction with mediations for the treatment of opioid use disorder; special populations (pregnant women, individuals with pain, adolescents, individuals with co-occurring psychiatric disorders, individuals in the criminal justice system); and naloxone for the treatment of opioid overdose.
This article only summarizes those areas most relevant to pediatricians and other healthcare providers in treating opioid dependence or addiction in children and adolescents. Tables 1 and 2 summarize clinical recommendations that pertain to all populations with opioid dependence, and can be relevant for (but are not specific to) children and adolescents. These tables provide only a brief summary, therefore readers are urged to read the full clinical guideline. Table 3 summarizes recommendations specific for adolescents.