Inpatient Opioid Withdrawal Management of Street Children and Adolescents Admitted to Child and Adolescent Psychiatric Ward: A Preliminary Case Series|
Moghadam, Mahboubeh Firouzkouhi; Hashemian, Seyed-Sepehr; Pishjoo, Masoud; Ghasemi, Sanaz; Hajebi, Ahmad & Noroozi, Alireza
Background: About 10 million children worldwide live or work on the street. International reports estimate the prevalence of
substance use among street children to be between 25% - 90%, which is who were referredntal disorders and high-risk behaviors.
Objectives: The objective of this study was to report the outcomes of assisted withdrawal of opioid-dependent vulnerable children
and adolescents who were referred to child and adolescent psychiatric ward of Ali Ebne Abitaleb hospital, an academic hospital in
Methods: Clinical chart abstractions were performed on a convenience sample of 40 serial opioid-dependent street children and
adolescents (mean age: 11.14 ± 3.6 years) who were referred to child and adolescent psychiatric ward of Ali Ebne Abitaleb treatment
and research center from November 2014 to May 2015. The demographic data, drug use history, comorbid physical and psychiatric
conditions, symptomatology of opioid withdrawal syndrome, pharmacotherapies and psychosocial services, length of hospital stay,
and any adverse events were extracted from the patients’ files using a checklist developed by the authors.
Results: Twenty-four (60%) patients were male, and 16 (40%) were female. The main drug used by all patients was opioids. Heroin
Kerack (which has a street name of crystal in southeast Iran) was the most common (75%) drug of use, followed by opium (10%) and
opium residue (7.5%). None of the participants self-reported using injected drugs. The high rate of a lack of eligibility for guardianship
was documented among parents (87.5%) mainly due to their use of illegal drugs. Musculoskeletal pain and diarrhea were the
most common withdrawal symptoms of the patients upon admission. The mean length of stay was 10.8 (± 7.30) days, and no significant
adverse events were reported during the symptomatic treatment of opioid withdrawal syndrome.
Conclusions: To our knowledge, this is the first study to report on the safety and feasibility of inpatient symptomatic pharmacological
treatment for assisted withdrawal among opioid-dependent children and adolescents in Iran. More well-designed studies
to investigate the long-term outcomes of opioid treatment among children are warranted.
Vulnerable Children; Substance Use; Assisted Withdrawal; Inpatient