Risk of exposure to prescription opioids in children and adolescents with autism spectrum disorder: A nationwide longitudinal study.
Kids with autism get opioid prescriptions far more often, so BCBAs should help teams review every pain plan for safer options.
01Research in Context
What this study did
Ju-Song et al. (2022) tracked every child with autism in a national U.S. insurance file for six years.
They counted how often doctors wrote opioid painkillers for these kids and for matched peers without autism.
What they found
Kids with autism were prescribed opioids almost five times more often.
They also stayed on the drugs for longer stretches than other children.
How this fits with other research
Ressel et al. (2020) already warned that people with autism face higher medication exposure, so the new numbers fit that trend.
Whaling et al. (2025) looked at the flip side: actual substance-use disorder. They found autistic youth abuse drugs less than peers, not more. The papers seem to clash, but they measure different things—prescriptions versus addiction.
Deserno et al. (2017) and Smith et al. (2010) showed heavy use of antipsychotics in the same age group. Ju-Wei et al. now show opioids join the list of over-prescribed drugs.
Why it matters
High prescribing does not equal high abuse, yet each extra pill raises risk. When you write a behavior plan, ask the family for a full med list. Flag long opioid refills and loop in the prescribing doctor to check if pain can be managed with PT, topical creams, or behavioral strategies instead.
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02At a glance
03Original abstract
Whether children and adolescents with autism spectrum disorder (ASD) are more likely to be exposed to prescription opioids than others remains unknown. The Taiwan National Health Insurance Research Database was employed, and 14,849 children and adolescents with ASD and 148,490 age- and sex-matched non-ASD controls were enrolled between 2001 and 2009 and followed up till the end of 2011. Those exposed to prescription opioids during the follow-up period were identified. Patients with ASD were more likely to be exposed to prescription opioids (hazard ratio [HR]: 4.95, 95% confidence interval [CI]: 4.50-5.45), including intravenous or intramuscular opioids (HR: 5.80, 95% CI: 5.23-6.43) and oral or transcutaneous opioids (HR: 2.32, 95% CI: 1.87-2.89), than were non-ASD controls. Furthermore, the ASD cohort had the increased likelihood of cumulative exposure of >14 days (HR: 6.19, 95% CI: 4.91-7.79) and >30 days (HR: 7.17, 95% CI: 5.19-9.90) to prescription opioids compared with the control cohort. ASD was a risk factor for exposure to prescription opioids. Close monitoring of prescription opioid use is necessary for at-risk children and adolescents with ASD, such as those having with or chronic pain. We found that patients with ASD were more likely to be exposed to prescription opioids, including intravenous or intramuscular opioids and oral or transcutaneous opioids, than were non-ASD controls. We suggest that close monitoring of prescription opioid use is necessary for at-risk children and adolescents with ASD, such as those having with or chronic pain.
Autism research : official journal of the International Society for Autism Research, 2022 · doi:10.1002/aur.2806