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Comment & Response
June 2, 2021

Concerns About Pediatric Opioid Prescribing Guidelines—Reply

Author Affiliations
  • 1Division of Pediatric Surgery, Children’s Hospital Los Angeles, Los Angeles, California
  • 2Department of Surgery, Keck School of Medicine of the University of Southern California, Los Angeles
  • 3Department of Preventive Medicine, University of Southern California, Los Angeles
  • 4Division of Pain Medicine, Department of Anesthesiology and Critical Care Medicine, Children’s Hospital Los Angeles, Los Angeles, California
JAMA Surg. 2021;156(9):892-893. doi:10.1001/jamasurg.2021.2087

In Reply We thank Agarwal et al for their comments as several important points were raised in their Letter to the Editor. We agree that it would be concerning to emphasize avoiding opioids altogether. However, this concern misrepresents our article and guidelines.1 Throughout the article, we clearly state the need to recognize opioid-related risks, maximize nonopioid regimens, and educate families appropriately.1 Rather than suggesting opioid avoidance, we advocate for an evidence-based approach to alternative pain strategies with the goal of minimizing opioid-related risks. As the opioid epidemic is largely limited to the United States, the majority of cited research was conducted in the US, and the project was supported by the American Pediatric Surgical Association; care should be taken to appropriately apply these guidelines in settings outside of those reviewed.

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