CAPE – Prevalence of chronic pain or analgesic use in children and young people and its long-term impact on substance misuse, mental illness, and prescription opioid use: a retrospective longitudinal cohort study

By Andrew Lambarth and colleagues. Published in the Lancet, Regional Health – Europe journal, link here.

Background

Long-term pain affects approximately one quarter of children and in 8% the pain can be intense and frequently recurring. It is not certain whether there are long-term health implications for persistent pain in childhood.

Study aims and objectives

The study aimed to investigate the scale of persistent pain and long-term painkiller use in children and young people, and if they were associated with substance misuse, use of prescription opioids, and poor mental health in adulthood

Study findings and conclusions

The study used electronic health records from 853,625 individuals and those with persistent pain or painkiller prescriptions were compared to those where this was not recorded. When young people started painkiller use or had persistent pain they were mainly between 14 to 22 years old. In later life, these young people had a 31% and 17% higher risk of worse mental health and substance misuse outcomes.

Painkiller prescriptions or persistent pain was associated with using opioids at double the rate that would be expected. Repeated painkiller prescriptions were associated with substance misuse in later life, and there was a possibility that some vulnerable groups of young people were being over-prescribed.

Future directions for researchers and health professionals

The study recommended that healthcare professionals focus on timely pain recognition and increased use of non-pharmacological options to minimize the dangers of overprescribing analgesic medicines to this vulnerable population.