Skip to main content

Advertising Disclaimer »

Main menu

  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors/Reviewers
    • Submit Manuscript
    • Author Guidelines
    • Reviewer Guidelines
    • Open Access
    • Editorial Policies
  • Content
    • Current Issue
    • Online First
    • Archive
    • Blogs
    • Topic/Program Collections
    • AAP Meeting Abstracts
  • Pediatric Collections
    • COVID-19
    • Racism and Its Effects on Pediatric Health
    • More Collections...
  • AAP Policy
  • Supplements
  • Multimedia
    • Video Abstracts
    • Pediatrics On Call Podcast
  • Subscribe
  • Alerts
  • Careers
  • Other Publications
    • American Academy of Pediatrics

User menu

  • Log in
  • My Cart

Search

  • Advanced search
American Academy of Pediatrics

AAP Gateway

Advanced Search

AAP Logo

  • Log in
  • My Cart
  • Journals
    • Pediatrics
    • Hospital Pediatrics
    • Pediatrics in Review
    • NeoReviews
    • AAP Grand Rounds
    • AAP News
  • Authors/Reviewers
    • Submit Manuscript
    • Author Guidelines
    • Reviewer Guidelines
    • Open Access
    • Editorial Policies
  • Content
    • Current Issue
    • Online First
    • Archive
    • Blogs
    • Topic/Program Collections
    • AAP Meeting Abstracts
  • Pediatric Collections
    • COVID-19
    • Racism and Its Effects on Pediatric Health
    • More Collections...
  • AAP Policy
  • Supplements
  • Multimedia
    • Video Abstracts
    • Pediatrics On Call Podcast
  • Subscribe
  • Alerts
  • Careers

Discover Pediatric Collections on COVID-19 and Racism and Its Effects on Pediatric Health

American Academy of Pediatrics
Article

Prescription Opioid Misuse and Risky Adolescent Behavior

Devika Bhatia, Susan K. Mikulich-Gilbertson and Joseph T. Sakai
Pediatrics February 2020, 145 (2) e20192470; DOI: https://doi.org/10.1542/peds.2019-2470
Devika Bhatia
Department of Psychiatry, School of Medicine, University of Colorado Denver, Aurora, Colorado
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Susan K. Mikulich-Gilbertson
Department of Psychiatry, School of Medicine, University of Colorado Denver, Aurora, Colorado
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Joseph T. Sakai
Department of Psychiatry, School of Medicine, University of Colorado Denver, Aurora, Colorado
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • Supplemental
  • Info & Metrics
  • Comments
Loading
Download PDF

Abstract

Video Abstract

OBJECTIVES: Misuse of opioid medications (ie, using opioids differently than how a doctor prescribed the medication) is common among US adolescents and associated with preventable health consequences (eg, severe respiratory depression, seizures, heart failure, and death).1 New guidelines and recommendations have made providers more attuned to overprescribing and more vigilant about screening for opioid misuse.2 We hypothesized that youth who misused prescription opioids were more likely to report engaging in a broad range of other risky behaviors.

METHODS: We used the Centers for Disease Control and Prevention’s 2017 Youth Risk Behavior Surveillance Survey (n = 14 765), a cross-sectional, nationally representative survey of high school students. Students were sampled by using a 3-stage random cluster design. We conducted weighted logistic regressions to determine the strength of the association between our independent variable, ever misusing prescription opioids, and 22 dependent variables in the following categories: risky driving behaviors (4 variables), violent behaviors (3 variables), risky sexual behaviors (4 variables), substance use (10 variables), and suicide attempt (1 variable).

RESULTS: In 2017, 14% of US adolescents reported ever misusing opioids. Those who misused prescription opioids were significantly more likely to have engaged in all 22 risky behaviors (adjusted odds ratios ranged from 2.0 to 22.3; P < .0001 for all tests) compared with other adolescents.

CONCLUSIONS: Adolescents reporting ever misusing prescription opioids were more likely to have engaged in a broad range of risky behaviors. Health care providers screening for prescription opioid misuse may be ideally positioned to identify these high-risk youth and initiate early interventions.

  • Abbreviations:
    CDC —
    Centers for Disease Control and Prevention
    CI —
    confidence interval
    YRBSS —
    Youth Risk Behavior Surveillance Survey
  • What’s Known on This Subject:

    Studies have examined risk profiles of youth who misuse prescription drugs (most examining multiple prescription medications), showing misuse is associated with risky behaviors, including risky driving, risky sexual behaviors, suicidal behaviors, and substance abuse (many studies using a single school or region).

    What This Study Adds:

    Using a nationally representative sample, we conducted a comprehensive assessment of risky behaviors in adolescents reporting prescription opioid misuse. We report large, statistically significant associations between opioid misuse and a broad range of risky behaviors and identify behaviors targetable for intervention.

    More than 88 0000 American youth aged 12 to 17 reported misuse of opioid pain medications in 2016 (ie, used differently than how a doctor prescribed the medication),3 making prescription pain medications the second most commonly abused illicit substance among American youth.4 Prescription pain medication misuse has been increasing over the past 20 years,5 and hospitalizations for opioid poisoning among children have increased at a concerning rate.6 The misuse of opioids more generally has escalated to the level of an epidemic in the United States,5 and work has begun to focus on predicting which children are at greater risk for prescription opioid misuse.7

    Prescription pain medication misuse can have serious deleterious health consequences, including severe respiratory depression, seizures, heart failure, and death, for example, from inadvertent overdose.5 Perhaps most concerning, opioid pain medication misuse predicts future development of an opioid use disorder.8 Thus, the potential consequences of prescription opioid misuse among adolescents can be severe and life-threatening.

    Several studies have examined risk profiles of adolescents and young adults who misuse prescription drugs. These studies have shown that prescription opioid misuse is associated with some risky behaviors, such as risky driving, risky sexual behaviors, and substance abuse. However, many studies examined these risky behaviors in isolation or only examined past-year prescription medication misuse.9–16 Additionally, many of the studies were relatively small, focusing on 1 school or 1 geographic region.9–11,16 Understanding the comprehensive risk profile of youth who misuse prescription opioids is of importance to pediatricians, who are well positioned to detect and provide early and targeted interventions.

    Here we hypothesize that youth with a history of prescription opioid misuse may be at higher risk for a broad range of risky behaviors that may contribute to overall morbidity. These include but are not limited to use of other (nonopioid) substances, violent behavior, suicide attempts, risky driving behavior, and risky sexual behavior. Understanding the types of risky behaviors associated with prescription pain medication misuse in adolescents could heighten awareness of health care providers to screen for a broad range of risky behaviors among youth with prescription opioid misuse with the ultimate goal of reducing morbidity and premature mortality in this vulnerable population.

    Methods

    Participants

    Data on participants were drawn from the Youth Risk Behavior Surveillance Survey (YRBSS), a cross-sectional study conducted by the Centers for Disease Control and Prevention (CDC) in 2017 (n = 14 765). This is a nationally representative school-based survey that uses a 3-stage, cluster sample design of US students in grades 9 to 12 in public, Catholic, and other private schools. The CDC obtained samples from all 50 states and the District of Columbia. They first identified large-size counties or adjacent smaller counties from which to select schools geographically (primary sampling units). In the second stage, a list of public and private schools was selected by using the Market Data Retrieval database so as to obtain a wide cross-section of the different types of schools attended by American youth. In the third stage of sampling, the CDC randomly selected 1 or 2 entire classes in each chosen school and in each of the grades, 9 to 12, in which all students of the sampled class were eligible to participate.17

    Measures

    Our independent variable of interest was any misuse of prescription pain medication or prescription opioid misuse. YRBSS queried, “During your life, how many times have you taken a prescription pain medication differently than how a doctor told you to use it (count drugs such as codeine, Vicodin, Oxycontin, hydrocodone, and Percocet)?”; misuse was considered positive for responses indicating use 1 or more times and negative for responses of 0 times.

    We identified 22 outcome variables and categorized them into broader domains of risky behavior, including (1) risky driving behavior (4 variables), (2) risky sexual behavior (4 variables), (3) risky substance use behavior (10 variables), (4) suicide attempt (1 variable), and (5) risky violent behavior (3 variables). See Supplemental Table 3 for definitions of these variables.

    Potential confounders measured in the 2017 YRBSS that were adjusted for in the analyses included sex, age (in years), and race and/or ethnicity. Race and/or ethnicity categories were defined per the YRBSS manual.18

    Data Analyses

    Data were analyzed by using SAS statistical software version 9.4 (SAS Institute, Inc, Cary, NC). Special sample survey procedures that are appropriate for analyzing complex survey data such as in the YRBSS with appropriate specifications on the STRATA, CLUSTER, and WEIGHT statements were used. The SAS procedure Proc SurveyFreq was used to generate weighted frequencies of each variable overall and by opioid misuse group (yes or no), and Proc SurveyLogistic was used to conduct multiple logistic regression analyses to determine the strength of the association between each outcome and opioid misuse group (yes or no), adjusting for demographic characteristics. To provide adjustment for the number of outcomes (n = 22) studied, we divided the usual significance threshold (0.05) by 22 and considered P <.002 to be statistically significant in all analyses.

    Results

    Demographics of the Study Sample

    Study participant characteristics are provided in Table 1. The study cohort included 14 765 participants; 49.3% were of male sex, and 53.5% were non-Hispanic whites. Overall, 14% of the youth reported ever misusing prescription opioids. There was no statistically significant difference in those who reported opioid misuse compared with those who did not by sex (P = .2) or race and/or ethnicity (P = .005), but significant differences were seen by age (P < .0001). There was an overrepresentation of 17- and 18-year-olds in the opioid misuser category.

    View this table:
    • View inline
    • View popup
    TABLE 1

    Demographics of Students Sampled, Comparing Opioid Misusers and Nonmisusers

    Opioid Misuse and Other Risky Behaviors

    Risky Driving Behavior

    In this cross-sectional sample, students who reported ever misusing prescription opioids, compared with those who never misused, were 2.8 times more likely to report never or rarely using a seatbelt (confidence interval [CI] 2.28–3.49; P < .0001), 2.8 times more likely to have ridden with an intoxicated driver (CI 2.40–3.36; P < .0001), 5.8 times more likely to have driven under the influence (CI 4.30–7.70; P < .0001), and 2.3 times more likely to have texted or e-mailed while driving (CI 2.00–2.65; P < .0001; Table 2).

    View this table:
    • View inline
    • View popup
    TABLE 2

    Association of Risky Behaviors With Opioid Misuse

    Risky Sexual Behavior

    Students who reported ever misusing prescription opioids were 3.9 times more likely to have reported first sexual intercourse before age 13 (CI 2.88–5.40; P < .0001), 4.8 times more likely to have reported sex with 4 or more partners (CI 3.89–5.98; P < .0001), 3.6 times more likely to have used substances before last sexual intercourse (CI 2.87–4.59; P < .0001), and 2.0 times more likely to have not used a condom before last sexual intercourse (CI 1.69–2.35; P < .0001; Table 2).

    Substance Use

    There were 10 variables representing substance use (Supplemental Table 3). Students who reported ever misusing prescription opioids were significantly more likely to have ever tried other substances (adjusted odds ratios ranged from 5.4 to 22.3; P < .0001 for all associations; Table 2).

    Suicide Attempt

    Students who reported ever misusing prescription opioids were 4.9 times more likely to have ever attempted suicide (CI 3.89–6.11; P < .0001; Table 2).

    Violent Behavior

    Students who reported ever misusing prescription opioids were 3.4 times more likely to have carried a weapon in the past 30 days (CI 2.92–3.91; P < .0001), 5.1 times more likely to have carried a gun in the past 30 days (CI 4.17–6.31; P < .0001), and 4.0 times more likely to have engaged in physical fights in the past year (CI 3.56–4.56; P < .0001; Table 2).

    Discussion

    Our aim in this study was to undertake a comprehensive evaluation of the relation between prescription opioid misuse and other risky behaviors in youth as assessed in the 2017 YRBSS. Prescription opioid pain medication misuse was significantly associated with all risky behaviors measured in this study even after adjusting for covariates. These included risky driving behaviors, violent behaviors, risky sexual behaviors, other substance use, and suicide attempts.

    Previous studies have examined 1 or 2 risky behaviors or examined only past-year prescription medication misuse.9–11,15,19 Our study, by comparison, more comprehensively assessed risky behaviors in several categories. Additionally, many of the existing studies were smaller, focusing on 1 school or 1 geographic region.9,10,15,19–21 Given that our study is of a nationally representative sample, we were able to provide a more generalizable assessment of the risky behaviors associated with prescription opioid misuse. Furthermore, much of the existing literature examined prescription drug misuse (including medications such as stimulants, benzodiazepines, steroids, and pain relievers) and did not address opioid use specifically.10,19–21 By contrast, we were able to more specifically describe the relationship between opioid misuse and risky behavior, thus more precisely characterizing this high-risk population and providing evidence for early targeted interventions.

    There are several possible explanations for the causes of the association observed in this study. There is evidence in the literature that those who misuse prescription opioids then engage in other high-risk behaviors. Studies have examined the progression of prescription opioid use to use of other substances, specifically heroin.22 Alternatively, there is evidence that high-risk–takers are also more likely to engage in other risky behaviors, and thus, prescription opioid misuse may be part of the high-risk–taker profile.23 However, because of the cross-sectional design of this study, we could not determine the direction of the association.

    Our findings have several implications for clinicians prescribing opioid pain medications or providing care for those taking prescription opioid pain medications. Although recognizing that our results cannot determine causality, it seems prudent for physicians to not only discuss with patients and their parents the direct dangers of misuse of prescribed opioid pain medications but also review the observed associations between opioid misuse and other risky behaviors. When physicians and other providers identify youth misusing prescription opioids, they should have a heightened awareness of associated risky behaviors and potential opportunities for education and prevention (eg, advising about riding in a car with an intoxicated driver). The opposite directionality of associations should also be considered. For example, school sexual health educators should consider the greater likelihood of misuse of prescription opioid medications among youth engaging in high-risk sexual behaviors. Additionally, psychiatrists evaluating patients for self-harm risk should take into consideration misuse of prescription opioid medications as a risk factor for suicide attempt.

    There were a few limitations in the current study that should be considered when interpreting the results. First, the study was cross-sectional, limiting the ability to determine causality of outcomes. However, this study provides a snapshot of the risky behaviors associated with prescription opioid misuse. Furthermore, additional covariates such as socioeconomic status, mental health disorders, and performance in school were not asked about in the YRBSS but may have implications on the results. Additionally, the motivations to misuse prescription opioid medications and source of prescription and/or access to the opioid mediations were not assessed in this survey, and as such, no conclusions can be made directly via this study. Finally, the current data rely on self-reporting, which could be subject to recall and/or unacceptability bias.

    These limitations notwithstanding, we report that adolescents who misuse prescription opioids are more likely to have engaged in a broad range of other risky behaviors, all of which contribute to significant adverse health outcomes. Future efforts should be focused on better understanding the directionality of this association. Additionally, preventing access to prescription opioids will help minimize overall risk in this group. With the ongoing opioid epidemic, pediatricians and child psychiatrists are likely to be more attuned to opioid misuse in their patients. If youth are screening positive for opioid misuse, pediatricians, nurses, social workers, child psychiatrists, and other providers assessing adolescents may have a new, broad range of other risky behaviors for which to screen regardless of the direction of the association.

    Footnotes

      • Accepted October 7, 2019.
    • Address correspondence to Devika Bhatia, MD, University of Colorado School of Medicine, 13001 E 17th Place, Aurora, CO 80045. E-mail: devikabhatia47{at}gmail.com
    • FINANCIAL DISCLOSURE: The authors have indicated they have no financial relationships relevant to this article to disclose.

    • FUNDING: No external funding.

    • POTENTIAL CONFLICT OF INTEREST: The authors have indicated they have no potential conflicts of interest to disclose.

    References

    1. ↵
      1. Chou R,
      2. Turner JA,
      3. Devine EB, et al
      . The effectiveness and risks of long-term opioid therapy for chronic pain: a systematic review for a National Institutes of Health Pathways to Prevention Workshop. Ann Intern Med. 2015;162(4):276–286
      OpenUrlCrossRefPubMed
    2. ↵
      1. Twombly EC,
      2. Holtz KD
      . Teens and the misuse of prescription drugs: evidence-based recommendations to curb a growing societal problem. J Prim Prev. 2008;29(6):503–516
      OpenUrlCrossRefPubMed
    3. ↵
      1. Kann L,
      2. McManus T,
      3. Harris WA, et al
      . Youth risk behavior surveillance - United States, 2017. MMWR Surveill Summ. 2018;67(8):1–114
      OpenUrlCrossRefPubMed
    4. ↵
      1. Center for Behavioral Health Statistics and Quality
      . Behavioral health trends in the United States: results from the 2014 National Survey on Drug Use and Health. Available at: https://www.samhsa.gov/data/sites/default/files/NSDUH-FRR1-2014/NSDUH-FRR1-2014.pdf. Accessed October 31, 2019
    5. ↵
      1. Volkow ND
      . America’s addiction to opioids: heroin and prescription drug abuse. Available at: https://archives.drugabuse.gov/testimonies/2014/americas-addiction-to-opioids-heroin-prescription-drug-abuse. Accessed June 1, 2019
    6. ↵
      1. Gaither JR,
      2. Leventhal JM,
      3. Ryan SA,
      4. Camenga DR
      . National trends in hospitalizations for opioid poisonings among children and adolescents, 1997 to 2012. JAMA Pediatr. 2016;170(12):1195–1201
      OpenUrl
    7. ↵
      1. Young AM,
      2. Glover N,
      3. Havens JR
      . Nonmedical use of prescription medications among adolescents in the United States: a systematic review. J Adolesc Health. 2012;51(1):6–17
      OpenUrlCrossRefPubMed
    8. ↵
      1. McCabe SE,
      2. West BT,
      3. Morales M,
      4. Cranford JA,
      5. Boyd CJ
      . Does early onset of non-medical use of prescription drugs predict subsequent prescription drug abuse and dependence? Results from a national study. Addiction. 2007;102(12):1920–1930
      OpenUrlCrossRefPubMed
    9. ↵
      1. Asbridge M,
      2. Cartwright J,
      3. Langille D
      . Driving under the influence of opioids among high school students in Atlantic Canada: prevalence, correlates, and the role of medical versus recreational consumption. Accid Anal Prev. 2015;75:184–191
      OpenUrl
    10. ↵
      1. Bonar EE,
      2. Cunningham RM,
      3. Chermack ST, et al
      . Prescription drug misuse and sexual risk behaviors among adolescents and emerging adults. J Stud Alcohol Drugs. 2014;75(2):259–268
      OpenUrlCrossRefPubMed
    11. ↵
      1. Benotsch EG,
      2. Koester S,
      3. Luckman D,
      4. Martin AM,
      5. Cejka A
      . Non-medical use of prescription drugs and sexual risk behavior in young adults. Addict Behav. 2011;36(1–2):152–155
      OpenUrlCrossRefPubMed
      1. McCauley JL,
      2. Amstadter AB,
      3. Macdonald A, et al
      . Non-medical use of prescription drugs in a national sample of college women. Addict Behav. 2011;36(7):690–695
      OpenUrlCrossRefPubMed
      1. McCabe SE,
      2. Teter CJ,
      3. Boyd CJ
      . Illicit use of prescription pain medication among college students. Drug Alcohol Depend. 2005;77(1):37–47
      OpenUrlCrossRefPubMed
      1. Zullig KJ,
      2. Divin AL
      . The association between non-medical prescription drug use, depressive symptoms, and suicidality among college students. Addict Behav. 2012;37(8):890–899
      OpenUrlCrossRefPubMed
    12. ↵
      1. Ashrafioun L,
      2. Bishop TM,
      3. Conner KR,
      4. Pigeon WR
      . Frequency of prescription opioid misuse and suicidal ideation, planning, and attempts. J Psychiatr Res. 2017;92:1–7
      OpenUrl
    13. ↵
      1. Murphy SM,
      2. McPherson S,
      3. Robinson K
      . Non-medical prescription opioid use and violent behaviour among adolescents. J Child Adolesc Ment Health. 2014;26(1):35–47
      OpenUrl
    14. ↵
      1. Brener ND,
      2. Kann L,
      3. Shanklin S, et al; Centers for Disease Control and Prevention (CDC)
      . Methodology of the youth risk behavior surveillance system–2013. MMWR Recomm Rep. 2013;62(RR):1–20
      OpenUrlPubMed
    15. ↵
      1. Centers for Disease Control and Prevention
      . 2017 YRBS data users guide. Available at: https://www.cdc.gov/healthyyouth/data/yrbs/pdf/2017/2017_YRBS_Data_Users_Guide.pdf. Accessed October 31, 2019
    16. ↵
      1. Wells BE,
      2. Kelly BC,
      3. Rendina HJ,
      4. Parsons JT
      . Prescription drug misuse and sexual behavior among young adults. J Sex Res. 2015;52(6):659–668
      OpenUrlCrossRefPubMed
      1. Levine SB,
      2. Coupey SM
      . Nonmedical use of prescription medications: an emerging risk behavior among rural adolescents. J Adolesc Health. 2009;44(4):407–409
      OpenUrlCrossRefPubMed
    17. ↵
      1. McCabe SE,
      2. Boyd CJ,
      3. Teter CJ
      . Subtypes of nonmedical prescription drug misuse. Drug Alcohol Depend. 2009;102(1–3):63–70
      OpenUrlCrossRefPubMed
    18. ↵
      1. Guarino H,
      2. Mateu-Gelabert P,
      3. Teubl J,
      4. Goodbody E
      . Young adults’ opioid use trajectories: from nonmedical prescription opioid use to heroin, drug injection, drug treatment and overdose. Addict Behav. 2018;86:118–123
      OpenUrl
    19. ↵
      1. Monshouwer K,
      2. Harakeh Z,
      3. Lugtig P, et al
      . Predicting transitions in low and high levels of risk behavior from early to middle adolescence: the TRAILS study. J Abnorm Child Psychol. 2012;40(6):923–931
      OpenUrlCrossRefPubMed
    • Copyright © 2020 by the American Academy of Pediatrics
    PreviousNext
    Back to top

    Advertising Disclaimer »

    In this issue

    Pediatrics
    Vol. 145, Issue 2
    1 Feb 2020
    • Table of Contents
    • Index by author
    View this article with LENS
    PreviousNext
    Email Article

    Thank you for your interest in spreading the word on American Academy of Pediatrics.

    NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

    Enter multiple addresses on separate lines or separate them with commas.
    Prescription Opioid Misuse and Risky Adolescent Behavior
    (Your Name) has sent you a message from American Academy of Pediatrics
    (Your Name) thought you would like to see the American Academy of Pediatrics web site.
    CAPTCHA
    This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
    Request Permissions
    Article Alerts
    Log in
    You will be redirected to aap.org to login or to create your account.
    Or Sign In to Email Alerts with your Email Address
    Citation Tools
    Prescription Opioid Misuse and Risky Adolescent Behavior
    Devika Bhatia, Susan K. Mikulich-Gilbertson, Joseph T. Sakai
    Pediatrics Feb 2020, 145 (2) e20192470; DOI: 10.1542/peds.2019-2470

    Citation Manager Formats

    • BibTeX
    • Bookends
    • EasyBib
    • EndNote (tagged)
    • EndNote 8 (xml)
    • Medlars
    • Mendeley
    • Papers
    • RefWorks Tagged
    • Ref Manager
    • RIS
    • Zotero
    Share
    Prescription Opioid Misuse and Risky Adolescent Behavior
    Devika Bhatia, Susan K. Mikulich-Gilbertson, Joseph T. Sakai
    Pediatrics Feb 2020, 145 (2) e20192470; DOI: 10.1542/peds.2019-2470
    del.icio.us logo Digg logo Reddit logo Twitter logo CiteULike logo Facebook logo Google logo Mendeley logo
    Print
    Download PDF
    Insight Alerts
    • Table of Contents

    Jump to section

    • Article
      • Abstract
      • Methods
      • Results
      • Discussion
      • Footnotes
      • References
    • Figures & Data
    • Supplemental
    • Info & Metrics
    • Comments

    Related Articles

    • PubMed
    • Google Scholar

    Cited By...

    • No citing articles found.
    • Google Scholar

    More in this TOC Section

    • Applications of Artificial Intelligence for Retinopathy of Prematurity Screening
    • Phenobarbital and Clonidine as Secondary Medications for Neonatal Opioid Withdrawal Syndrome
    • Severe Acute Neurologic Involvement in Children With Hemolytic-Uremic Syndrome
    Show more Articles

    Similar Articles

    Subjects

    • Substance Use
      • Substance Use
    • Psychiatry/Psychology
      • Psychiatry/Psychology
    • Journal Info
    • Editorial Board
    • Editorial Policies
    • Overview
    • Licensing Information
    • Authors/Reviewers
    • Author Guidelines
    • Submit My Manuscript
    • Open Access
    • Reviewer Guidelines
    • Librarians
    • Institutional Subscriptions
    • Usage Stats
    • Support
    • Contact Us
    • Subscribe
    • Resources
    • Media Kit
    • About
    • International Access
    • Terms of Use
    • Privacy Statement
    • FAQ
    • AAP.org
    • shopAAP
    • Follow American Academy of Pediatrics on Instagram
    • Visit American Academy of Pediatrics on Facebook
    • Follow American Academy of Pediatrics on Twitter
    • Follow American Academy of Pediatrics on Youtube
    • RSS
    American Academy of Pediatrics

    © 2021 American Academy of Pediatrics