CONTEXT Opioid-related harms continue to rise for children and youth. Analgesic prescribing decisions are challenging because the risk for future nonmedical opioid use or disorder is unclear. OBJECTIVE To synthesize research examining the association between short-term therapeutic opioid exposure and future nonmedical opioid use or opioid use disorder and associated risk factors. DATA SOURCES We searched 11 electronic databases. STUDY SELECTION Two reviewers screened studies. Studies were included if: they were published in English or French, participants had short-term (≤14 days) or an unknown duration of therapeutic exposure to opioids before 18 years, and reported opioid use disorder or misuse. DATA EXTRACTION Data were extracted, and methodologic quality was assessed by 2 reviewers. Data were summarized narratively. RESULTS We included 21 observational studies (49 944 602 participants). One study demonstrated that short-term therapeutic exposure may be associated with opioid abuse; 4 showed an association between medical and nonmedical opioid use without specifying duration of exposure. Other studies reported on prevalence or incidence of nonmedical use after medical exposure to opioids. Risk factors were contradictory and remain unclear. LIMITATIONS Most studies did not specify duration of exposure and were of low methodologic quality, and participants might not have been opioid naïve. CONCLUSIONS Some studies suggest an association between lifetime therapeutic opioid use and nonmedical opioid use. Given the lack of clear evidence regarding short-term therapeutic exposure, health care providers should carefully evaluate pain management options and educate patients and caregivers about safe, judicious, and appropriate use of opioids and potential signs of misuse.

中文翻译：

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儿童短期治疗暴露后的非医疗阿片类药物使用：系统评价。

背景 阿片类药物相关危害对儿童和青少年的危害持续增加。镇痛处方决定具有挑战性，因为未来非医疗阿片类药物使用或障碍的风险尚不清楚。目的 综合研究短期治疗性阿片类药物暴露与未来非医疗阿片类药物使用或阿片类药物使用障碍及相关风险因素之间的关联。数据来源 我们检索了 11 个电子数据库。研究选择 两名评审员筛选了研究。符合以下条件的研究被纳入：它们以英语或法语发表，参与者在 18 岁之前有短期（≤14 天）或未知持续时间的阿片类药物治疗暴露，并且报告了阿片类药物使用障碍或滥用。数据提取 数据被提取，方法学质量由 2 名评价员评估。数据被叙述性地总结。结果 我们纳入了 21 项观察性研究（49 944 602 名参与者）。一项研究表明，短期治疗暴露可能与阿片类药物滥用有关；图 4 显示了医疗和非医疗阿片类药物使用之间的关联，但未指定暴露持续时间。其他研究报告了医疗暴露于阿片类药物后非医疗使用的流行或发生率。危险因素相互矛盾，仍不清楚。局限性 大多数研究没有具体说明暴露持续时间，方法学质量低，参与者可能没有接触过阿片类药物。结论 一些研究表明终生治疗性阿片类药物使用与非医疗阿片类药物使用之间存在关联。鉴于缺乏关于短期治疗暴露的明确证据，