Chronic pain and opioid misuse occur in pediatric populations and can be associated with a range of negative adverse outcomes that may persist into adulthood. While the association between chronic pain, opioid prescribing, and opioid-related adverse consequences is reasonably well established in adults, the relation in pediatric patients is not well understood and the long-term impact of opioid exposure during childhood is yet to be fully revealed. The present review draws from the available literature on chronic and acute pediatric pain prevalence and treatment, opioid misuse, and adolescent substance use to address knowns and unknowns of comorbid pediatric chronic pain and opioid misuse. Additionally, gaps in knowledge regarding the prevalence and etiology of co-occurring chronic pain and opioid misuse in youth are identified. Hypothesized, modifiable risk factors associated with both pediatric pain and opioid misuse are considered. Due to a lack of empirically supported integrated treatments for comorbid chronic pain and opioid misuse in youth, this review examines the evidence base and best practices from both the chronic pain and opioid treatment literature to guide treatment recommendations for these comorbid conditions in youth. Recommendations are then provided to promote screening and mitigate risk of chronic pain and opioid misuse across a range of pediatric settings. Lastly, a comprehensive agenda to prevent and treat chronic pain and opioid misuse in adolescents and young adults is discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

中文翻译：

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青少年共病慢性疼痛和阿片类药物滥用：已知、未知和对行为治疗的影响。

慢性疼痛和阿片类药物滥用发生在儿科人群中，并可能与一系列可能持续到成年期的负面不良后果有关。虽然慢性疼痛、阿片类药物处方和阿片类药物相关不良后果之间的关联在成人中已相当明确，但在儿科患者中的关系尚不清楚，儿童时期阿片类药物暴露的长期影响尚未完全揭示。本综述借鉴了关于慢性和急性儿科疼痛患病率和治疗、阿片类药物滥用和青少年物质使用的现有文献，以解决合并儿科慢性疼痛和阿片类药物滥用的已知和未知问题。此外，还发现了关于青少年同时发生的慢性疼痛和阿片类药物滥用的流行和病因学方面的知识空白。假设，考虑了与儿科疼痛和阿片类药物滥用相关的可改变风险因素。由于缺乏针对青少年共病慢性疼痛和阿片类药物滥用的经验支持的综合治疗，本综述检查了慢性疼痛和阿片类药物治疗文献中的证据基础和最佳实践，以指导针对这些青少年共病的治疗建议。然后提供建议，以促进筛查并降低一系列儿科环境中慢性疼痛和阿片类药物滥用的风险。最后，讨论了预防和治疗青少年和年轻人慢性疼痛和阿片类药物滥用的综合议程。（PsycInfo 数据库记录 (c) 2020 APA，保留所有权利）。由于缺乏针对青少年共病慢性疼痛和阿片类药物滥用的经验支持的综合治疗，本综述检查了慢性疼痛和阿片类药物治疗文献中的证据基础和最佳实践，以指导针对这些青少年共病的治疗建议。然后提供建议，以促进筛查并降低一系列儿科环境中慢性疼痛和阿片类药物滥用的风险。最后，讨论了预防和治疗青少年和年轻人慢性疼痛和阿片类药物滥用的综合议程。（PsycInfo 数据库记录 (c) 2020 APA，保留所有权利）。由于缺乏针对青少年共病慢性疼痛和阿片类药物滥用的经验支持的综合治疗，本综述检查了慢性疼痛和阿片类药物治疗文献中的证据基础和最佳实践，以指导针对这些青少年共病的治疗建议。然后提供建议，以促进筛查并降低一系列儿科环境中慢性疼痛和阿片类药物滥用的风险。最后，讨论了预防和治疗青少年和年轻人慢性疼痛和阿片类药物滥用的综合议程。（PsycInfo 数据库记录 (c) 2020 APA，保留所有权利）。本综述检查了慢性疼痛和阿片类药物治疗文献中的证据基础和最佳实践，以指导针对这些青年合并症的治疗建议。然后提供建议，以促进筛查并降低一系列儿科环境中慢性疼痛和阿片类药物滥用的风险。最后，讨论了预防和治疗青少年和年轻人慢性疼痛和阿片类药物滥用的综合议程。（PsycInfo 数据库记录 (c) 2020 APA，保留所有权利）。本综述检查了慢性疼痛和阿片类药物治疗文献中的证据基础和最佳实践，以指导针对这些青年合并症的治疗建议。然后提供建议，以促进筛查并降低一系列儿科环境中慢性疼痛和阿片类药物滥用的风险。最后，讨论了预防和治疗青少年和年轻人慢性疼痛和阿片类药物滥用的综合议程。（PsycInfo 数据库记录 (c) 2020 APA，保留所有权利）。