Advancing advocacy for evidence-based opioid stewardship.

Opioids are frequently prescribed for postsurgical and acute pain management for both adults and children. However, research has shown that overprescription and improper handling of these medications contribute to problematic substance use, dependency, and overdose among the pediatric population. Despite increased awareness and efforts to mitigate the opioid epidemic, challenges persist, including inconsistent prescribing practices, inadequate education on safe disposal practices, gaps in prescription monitoring systems, and barriers to naloxone availability. In this review, we will highlight actionable steps and strategies for advocacy and intervention to reduce the burden of the opioid crisis in children and adolescents. Key topics include the critical role of opioid stewardship when managing postoperative pain, the importance of family engagement and education on safe disposal methods, the ongoing challenges of safe prescribing and monitoring, and opportunities to extend substance use screening and treatment referral for injured adolescents. Additionally, we will highlight policy recommendations to promote equitable access and availability of harm reduction tools such as naloxone. These strategies, if implemented together, can significantly reduce the risks associated with pediatric opioid use and mitigate the impact of the opioid epidemic on children and adolescents.