Appropriateness of Opioid Prescription in Children, Adolescents, and Younger Adults—The Elephant in the Room—Reply

In Reply We read with interest the commentary from Cortellazzo Wiel et al and thank them for highlighting an important point regarding our research on opioid prescribing practices in youth. The authors comment on the importance of opioid prescribing in certain settings, while also emphasizing avoidance of opioids when alternative pain management options are present. We agree that opioid prescribing must be evidence based, with recognition that opioids are an appropriate treatment for children with specific conditions (particularly severe acute pain; certain chronic diseases, such as cancer; and palliative care), but that their use should be counterbalanced with an understanding of potential opioid-related risks, including adverse effects, intentional or unintentional overdose, and risk of future opioid use disorder.