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Opioids for Children: Are They Ever Safe?

When you think of opioids, what comes to mind? A full-blown heroin addiction? A put-together suburban mother abusing painkillers and shopping from doctor to doctor? The devastating fentanyl crisis that's plaguing our country?

Regardless of your biases, there's probably one population you aren't considering: children.

But research shows that 3.5% of Americans between the ages of 0-21 have received prescription opioids. What's extremely concerning, however, is, that almost half of those pediatric opioid prescriptions are classified as high-risk. The reality is that, even from a young age, children can get hooked on narcotics.

So, what's a well-informed parent with good intentions supposed to do when their child is in pain? Let's get into it.

An Overview of Pediatric Pain Management

Pain management is undoubtedly a complex topic. Unfortunately, pain in children is often either overlooked or dismissed. Furthermore, young children who lack the ability to describe their symptoms, may not be able to accurately describe their discomfort- which can perpetuate the pain they feel.

To date, most of the research and treatment methods focus exclusively on adult populations. This also poses challenges for the medical community- and for the parents who want quick relief for their child's pain.

Children in acute pain may be prescribed opioid analgesics for immediate relief. This is common in serious injuries, fractures, or other related medical traumas. Opioids work by quickly alleviating or numbing the pain.

The problem, of course, lies in the addictive nature of the narcotic medication. While opioids can certainly be helpful for a single incident of pain, they are far riskier for treating chronic pain or pediatric pain without a specific origin.

Even if pediatric patients are well-monitored- and even if their parents safely dispense and dispose of medication as needed- are they at a heightened risk for substance abuse problems later?

Pros Of Narcotic Medication for Reducing Pediatric Pain

Children in severe pain often experience severe emotional distress.

Their pain can affect their temperament and jeopardize their relationships, self-esteem, and overall quality of life. Chronic pain, in particular, is correlated with poor academic achievement and higher rates of depression and anxiety.

Narcotic medication can be effective in treating infant and child pain in specific cases. Here are some of the benefits:

Fast Symptom Relief for Painful Procedures

In some cases, pediatric patients benefit from opioids, as these medications are some of the fastest ways to experience symptom relief. Narcotics like opioids provide fast relief for high levels of pain.

That's why they are often prescribed for children after they undergo surgery or some other physically painful event. These medications are highly-controlled and are meant to be a short-term pain option.

Narcotics Can Be Safe Options For Acute Pain Management

Acute pain refers to pain that results from a sudden injury or surgery. The pain severity can vary significantly, but it has a specific cause, and it dissipates over time.

Doctors typically prescribe narcotics for children experiencing acute pain. In these situations, the child takes medication for a short period of time- usually just 2-3 days. This short time span decreases the likelihood of building a tolerance or fostering a dependence.

Parents Can Monitor Pain Treatment Closely

When parents are on board and safely monitor medication, opioids can be a safe pain management option. It's important to keep medicine in a locked cabinet. Young children, in particular, should never have the ability to reach the medication themselves.

It's also important to get other non-narcotic medications to taper from the opioids. The faster a parent can do this, the less likely a child's body will become dependent. This is critical in treating acute pain.

Cons Of Narcotic Medication for Pediatric Pain Control

Although opioids provide immediate relief in decreasing pain in children, they come with significant drawbacks. All parents and doctors need to understand the risks of treating chronic pediatric pain with narcotics.

Opioid Tolerance Can Happen Quickly

Pediatric chronic pain patients may be at a higher risk for developing a tolerance. Acute and chronic pain is distressing for anyone, but children often lack the coping skills to manage their distress.

Young children have no concept of understanding the nature of forming a habit, and because their pain intensity may be so intense, both them (and their parents) may have a hard time managing this pain response appropriately.

More Long-Term Use Coincides With Addiction

Generally speaking, the longer someone takes narcotics for pain management, the greater their likelihood of developing an addiction. Opioids bind to the opioid receptors in the brain, which are responsible for dulling pain.

But they also trigger a sense of relief and pleasure. And because withdrawal symptoms can be so intense, many children and their parents are unprepared for that process.

Research also shows that addiction runs in families. Therefore, if one of the child's parents struggles to take pain medication as prescribed (or abuses opioids), the child may be at a higher risk for this problem.

Adolescents May Be More Prone to Addictive Behavior

Adolelscents are clearly more vulnerable to addiction than, say, a young child or infant.

Some of them may be prescribed opioids for a chronic illness or chronic and recurrent pain.

However, they may also be aware of the feel-good effects associated with opioids. If they have other risk factors- like depression, anxiety, or a history of trauma- they might be more likely to abuse their medication.

It's Important to Explore Other Pain Management Options

The American Pain Society works closely with the CDC to establish pain management guidelines for young children. Both organizations highlight the importance of reviewing other pain prevention medications before pursuing opioids. Acetaminophen, for instance, is shown to be effective for children.

What If Your Child Needs Pain Management Relief?

It can be heartbreaking to see your child in severe pain, especially when it's recurrent pain. Of course, you want the best pain medicine available, and of course, you want to mitigate the risk of substance use problems.

Fortunately, there are many methods that can help decrease pain for your child. Even if you can't eliminate pain, you can and should work with your child's treatment team to review your best options.

While opioids may seem like the best option for pain relief for children in the moment of distress, they come with some significant potential drawbacks that parents and doctors should be aware of.

How We Help With Pain Management

When a child is addicted to narcotics, comprehensive treatment is essential. It's crucial that your child's medical needs are taken into consideration to avoid acute pain relapses.

Medical detox may be recommended depending on the severity of the addiction. But pain assessment is nuanced, and that's why we recommend working with a qualified treatment team who understands the triage of chronic pain, addiction, and mental illness.

A professional family therapist can guide and support children as they work through these issues that, if left unaddressed, could prompt them to return to narcotics or seek out some other form of substance abuse.

If you or someone you know has a child struggling with narcotics addiction or any other type of mental disorder, we are here for you.

Contact us today to get started!

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