Open AccessLong-Term Neuropsychological Effects of Opioid Use in Children: A Descriptive Literature Review
Author(s) -
Gaurav Jain
Publication year - 2014
Publication title -
pain physician
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.31
H-Index - 99
eISSN - 2150-1149
pISSN - 1533-3159
DOI - 10.36076/ppj.2014/17/109
Subject(s) - medicine , neuropsychology , cinahl , clinical psychology , systematic review , cognition , medline , population , cochrane library , psychiatry , psychological intervention , randomized controlled trial , surgery , environmental health , political science , law
Background: Use of opioids in the management of pain and its consequences in childrenpresents a substantial challenge. A significant concern in pediatric pain management is the longterm neuropsychological consequences of opioids.Objectives: The authors aim to provide a descriptive review of the current literature surroundingthe neuropsychological impact of opioid use in children, along with possible extrapolations fromtheir use in adults and animal models.Study Design: Systematic review of published literature.Setting: Various universities in the United States.Methods: The electronic review for papers published between January 1992 and December 2012was conducted using Medline/Pubmed, PsychInfo, CINAHL, the Cochrane Library database, andGoogle Scholar.Results: Findings assessing pediatric pain patients treated with opioids demonstrated nosignificant differences in intelligence, behavior, vocabulary, or motor skills. One study reported adecrease in a visuo-constructional ability, which measured higher order executive function. Studiesfrom prenatal illicit opioid exposure found poorer performance on measures of language, verbalability, mathematics, reading, impulse control, and school readiness skills. The literature from adultprescribed opioid users has mixed results. Some showed impairment in the neuropsychologicaldomains of memory, decision-making, attention, concentration, information processing, psychomotor speed, visual special skills, and hand-eye coordination, while others found no differences orrevealed improved perceptual-cognitive status, possibly due to the removal of pain as a stressor.Limitations: Very few studies looked into the long term neuropsychological and cognitive effectsof the opioids in pediatric population. In an attempt to extrapolate from other groups, this reviewalso included literature from adult patients, prenatal opioid exposure, and animal studies.Conclusion: Opioid medications have the potential to produce long-lasting neuropsychologicalside effects. However, given the negative consequences of untreated pain, the potential benefitmay offset their risk. More studies are needed to clarify this complex interaction.Key words: Chronic pain management, infants, children, pediatrics, long term neurocognitiveeffects, opioid medication