Adolescent Outcomes of Post-Operative Opioid EXposure

The Adolescent outcomes of Post-operative opioid Exposure (APEX) study is a national study of surgical outcomes in adolescents.

Four million youth under 18 undergo surgery every year in the US, and surgery is often a young person's first exposure to prescription opioid pain medicine. Some patients who take prescription opioids after surgery may become dependent on that medication — with a small percentage of these patients developing  an opioid use disorder or addiction. Accidental drug poisoning is the leading cause of preventable death in the US. In 2022, more than 110,000 people died from opioid poisonings. Over the past five years, the rate of accidental drug poisonings has decreased among adults. However, it is increasing in adolescents and young adults.

In the Division of Addiction Medicine, we want to understand which adolescent populations are at the greatest risk of developing opioid-related problems after surgery through the APEX study. We hope that through our findings, we will be able to help prevent opioid problems in the future.

Learn more about the opioid overdose crisis.

APEX is funded by the National Institute on Drug Abuse Clinical Trials Network (NIDA CTN) and the National Institutes of Health Helping End Addiction Long-term (NIH HEAL) initiatives, and led by Boston Children’s Hospital.

We are actively recruiting 10,000 adolescents ages 12 to 17 who are undergoing surgery at hospitals across the country to participate. Participating patients and their caregivers will be asked to complete surveys for one year after surgery. In addition to their survey data, this research study will use information from patient medical records.

Our goal for APEX is to learn more about the use of opioid pain medication in adolescents who have recently had surgery, and understand how aspects of people’s lives affect their recovery process from surgery and pain management. In doing this, we can develop research-informed pain management protocols for adolescent surgical patients to reduce the risk of opioid use disorders in the future.