Society for Pediatric Pain Medicine
Better Care for Children in Pain

VISUAL PEARL

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QUESTION OF THE MONTH

A 15-year-boy presents for an urgent revision of a previous ankle dislocation after falling off his skateboard. His past history is significant for ADHD, and anxiety and ankle surgery 6 months ago. He started using marijuana when he was 13, and misused his opioid prescription after his previous surgery. He is very concerned about postoperative pain management and states that he had significant pain after his last surgery. On his way back to the OR he admits to using opioids or “whatever he can get his hands on” daily since that surgery, and that he seems to need higher and higher doses. He reports having tried to stop without success and is worried about withdrawal.

Which of the following terms best describes his probable current diagnosis?

A. Drug addict
B. Substance abuser
C. Prescription opioid abuser
D. Person with substance use disorder

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