Commentary Considerations of non-medical use of prescription opioids

Since the 1990’s there has been a significant increase in opioid prescribing and both medical and non-medical use of prescription opioids (NMUPO) with associated high rates of morbidity and mortality (Ling et al., 2011; Manchikanti et al., 2012a). This commentary will discuss NMUPO and considerations for pediatric pain management clinicians. NMUPO is defined as “the taking of prescription drugs [opioids], whether obtained by prescription or otherwise, other than in the manner or for the reasons or time period prescribed, or by a person for whom the drug was not prescribed” (United Nations Office on Drugs and Crime [UNODC], 2011, p. 1). NMUPO ranges from recreational use to self-medication and is not necessarily associated with substance use disorders (Boyd & McCabe, 2008; Frese & Eiden, 2011). The morbidity and mortality from NMUPO are significant and rising. In 2011, 29 % of emergency department (ED) visits for drug-related misuse or abuse in the United States were due to NMUPO, with 25 % requiring admission to hospita