{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T20:07:22Z","timestamp":1776283642243,"version":"3.50.1"},"reference-count":67,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T00:00:00Z","timestamp":1758672000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Background: Opioids are commonly used to manage both acute and chronic pain by acting on opioid receptors in the central and peripheral nervous systems. However, concerns about their increasing prescription and misuse have emerged due to adverse effects, toxicity, and the global impact of opioid-related harm. Objectives: This systematic review aims to evaluate the harmful (adverse and toxic) effects of prescribed opioids on the pediatric and the general population. Methods: Following PRISMA guidelines, a systematic search was conducted for data from January 2011 to December 2024 across selected electronic databases (PubMed\u00ae, SciELO\u00ae, Web of Science\u00ae, and EMBASE\u00ae) using a specific search strategy with Boolean operators. Cross-sectional, cohort, and case\u2013control designs published in English, analyzing and identifying the harmful effects of prescribed opioids in children and the general population, were eligible for inclusion. Three reviewers independently assessed titles and abstracts for eligibility, followed by a full-text review. A referee reviewer resolved discrepancies. Data extraction was performed for qualifying studies. The risk of bias was assessed by the ROBINS-I tool. Results: A total of 3984 papers were collected, with 1697 duplicates and 2062 non-eligible papers removed; resulting in 25 papers (112.825 patients) selected for qualitative analysis. The pediatric group experienced more harmful effects across multiple body systems (nausea and vomiting, hypotension, agitation, drowsiness\/lethargy, lethargy, respiratory depression, aspiration pneumonia) compared to the general population (dominant S wave, long QTc interval, right axis deviation, seizure). Conclusions: Despite the data heterogeneity, this study highlights the importance of evaluating the harmful effects of opioids, particularly in pediatric patients, to assess the risk\u2013benefit balance and health risks associated with their use. The lower number of effects in the general population may be attributed to increased pharmacological tolerance and tolerability.<\/jats:p>","DOI":"10.3390\/ph18101429","type":"journal-article","created":{"date-parts":[[2025,9,24]],"date-time":"2025-09-24T08:19:45Z","timestamp":1758701985000},"page":"1429","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Harmful Effects of Prescribed Opioids in Children and Adults: A Systematic Review"],"prefix":"10.3390","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3326-2296","authenticated-orcid":false,"given":"Lu\u00edza Siqueira","family":"Lima","sequence":"first","affiliation":[{"name":"Instituto de Pesquisa Pel\u00e9 Pequeno Pr\u00edncipe, Curitiba 80250-060, Brazil"},{"name":"Faculdades Pequeno Pr\u00edncipe, Curitiba 80230-020, Brazil"}]},{"given":"Nayara de S. da","family":"Costa","sequence":"additional","affiliation":[{"name":"Instituto de Pesquisa Pel\u00e9 Pequeno Pr\u00edncipe, Curitiba 80250-060, Brazil"},{"name":"Faculdades Pequeno Pr\u00edncipe, Curitiba 80230-020, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0032-9976","authenticated-orcid":false,"given":"Maria Eduarda A.","family":"Galiciolli","sequence":"additional","affiliation":[{"name":"Instituto de Pesquisa Pel\u00e9 Pequeno Pr\u00edncipe, Curitiba 80250-060, Brazil"},{"name":"Faculdades Pequeno Pr\u00edncipe, Curitiba 80230-020, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2861-2386","authenticated-orcid":false,"given":"Quelen I.","family":"Garlet","sequence":"additional","affiliation":[{"name":"Programa de P\u00f3s-Gradua\u00e7\u00e3o em Farmacologia, Centro Polit\u00e9cnico, Universidade Federal do Paran\u00e1, Curitiba 815300-000, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9979-0062","authenticated-orcid":false,"given":"Jo\u00e3o Jos\u00e9","family":"Joaquim","sequence":"additional","affiliation":[{"name":"ESTESC-Coimbra Health School, Instituto Polit\u00e9cnico De Coimbra, Farm\u00e1cia, 3045-043 Coimbra, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2004-5316","authenticated-orcid":false,"given":"Cl\u00e1udia S.","family":"Oliveira","sequence":"additional","affiliation":[{"name":"Instituto de Pesquisa Pel\u00e9 Pequeno Pr\u00edncipe, Curitiba 80250-060, Brazil"},{"name":"Faculdades Pequeno Pr\u00edncipe, Curitiba 80230-020, Brazil"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6279-1421","authenticated-orcid":false,"given":"Cristiano","family":"Matos","sequence":"additional","affiliation":[{"name":"ESTESC-Coimbra Health School, Instituto Polit\u00e9cnico De Coimbra, Farm\u00e1cia, 3045-043 Coimbra, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"104938","DOI":"10.1016\/j.phrs.2020.104938","article-title":"Opioid receptors beyond pain control: The role in cancer pathology and the debated importance of their pharmacological modulation","volume":"159","author":"Carli","year":"2020","journal-title":"Pharmacol. 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