Opioids and Children’s Pain

Opioids are one of many effective pain management tools for children with moderate to severe pain, but there is still uncertainty about the future harms from short-term prescribing. This is why healthcare providers need to prescribe responsibly.

When to Consider Prescribing Opioids

Use non-opioid treatments first. Consider your patient's pain and the treatment context when developing your treatment plan.

Always use physical and psychological interventions when treating pain.

When opioids are required to treat moderate and severe pain, add them to non-opioid treatment and interventions.

Potential Risks

Clinicians worry about the long-term eects of opioid use in children and youth. Asystematic review led by researchers at the University of Alberta shows that it is still unclear whether short-duration (≤2 weeks) therapeutic opioid use in children results in increased risk of non-medical use in the future. Some research indicates that exposure to therapeutic opioids at some point in a child's lifetime may be associated with non-medical opioid use.

Other factors that may increase or decrease the risk of future harm are also unclear.

Prescribing Guidance for Children and Youth

Health Canada recommends

No hydrocodone under 6

No codeine under 18

Limited tramadol under 18

Talking with Patients and Families

With increasing media coverage of the opioid crisis, patients and families are likely to have questions and concerns about opioid treatment plans. It is important that healthcare providers take the time to discuss safe usage, storage, and disposal of opioid prescriptions with families.Be sure to use clear and concise messaging in these conversations.

Here are 4 things to make sure your patients know:

Minimizing the Risks

A discussion on safer usage should include:

The importance of taking the appropriate dose and following the medication schedule

When to seek reassessment for under-treated pain

The potential warning signs of inappropriate use, suchas using opioids to help with their mood or to reduce anxiety, or taking more than prescribed

Discussing Safe Storage and Return

A discussion on safe storage should include:

The importance of keeping pills in their packaging and out of children’s reach

Safe return of remaining opioids to pharmacies

Useful Links

Find out more about opioids from these helpful resources:

ARCHE Systematic Review

TREKK Bottom Line Recommendations

Health Canada

PRODUCTION OF THIS MATERIAL WAS LED BY DR. MICHELE DYSON WITH ASSISTANCE FROM KELSEY WRIGHT AND ZAHRA SAIDHERSI

THIS MATERIAL WAS DEVELOPED WITH SUPPORT FROM:

Please feel free to distribute this infographic to your networks. Modifications of this work may not represent findings from this review. For any questions about modifications of this material, please contact mdyson@ualberta.ca.

This infographic and the associated review were supported by the Emergency Strategic Clinical Network (ESCN) and the Maternal Newborn Child & Youth Strategic Clinical Network (MNCY) through Alberta Health Services.