Despite Risks, Use of Opioids to Treat Migraine in Children is Common Across the U.S.

WASHINGTON, DC, JUNE 17, 2015 — Nearly one of every six children who receives medication for primary migraine or headache during their first medical visit is prescribed an opioid, despite evidence that such treatments increase a patient’s risk for migraine chronification (progressing from episodic to chronic status), medication overuse headaches, and treatment-related safety issues, according to a new study presented this week at the 57th Annual Scientific Meeting of the American Headache Society meeting here this week.
“Suboptimal pediatric migraine care can lead to decreased healthcare quality and increased healthcare costs,” said lead author Robert A. Nicholson, PhD, LCP, FAHS, and Director of Behavioral Medicine at Mercy Clinic Headache Center and Mercy Health Research in St. Louis. “We were concerned that pediatric patients may be prescribed opioids as a first-line acute intervention instead of evidence-based treatment.”
            Dr. Nicholson’s team utilized electronic health record data to identify 21,015 unique patients presenting to 1,284 unique providers with migraine or headache. These children and teens ages 6-17 presented for care across four states in metropolitan and non-metropolitan areas to primary care, specialty care, or Emergency Department/Urgent Care settings. Only a child’s first primary migraine or headache visit was analyzed.
            They found that girls and Caucasian children were at higher risk for being prescribed an opioid. Providers in ED/UC and specialty settings were more likely to prescribe an opioid than those in primary care. The rates are even higher among older teens ages 15-17, where one of every four who receives medication is prescribed an opioid.
            “There are significant dangers in prescribing opioids for migraine in children and teens,” he said, “and enormous need to increase provider awareness of the benefits of optimal migraine care.”
The American Headache Society Annual Scientific meeting draws about 1,000 headache and migraine researchers and treatment specialists from around the world to hear the latest scientific and clinical information on headache and migraine. This year’s program, “Drawing upon Headache Research,” is four days of teaching and scientific presentations.


The American Headache Society (AHS) is a professional society of health care providers dedicated to the study and treatment of headache and face pain. The Society’s objectives are to promote the exchange of information and ideas concerning the causes and treatments of headache and related painful disorders. Educating physicians, health professionals and the public and encouraging scientific research are the primary functions of this organization. AHS activities include an annual scientific meeting, a comprehensive headache symposium, regional symposia for neurologists and family practice physicians, publication of the journal Headache and sponsorship of the AHS Committee for Headache Education (ACHE). (www.americanheadachesociety.org)

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