The headlines about prescription opioid addiction and fatal overdoses are enough to scare any parent whose child needs pain medication.
But you needn’t fear giving your child prescribed painkillers, said Dr. Ibrahim Farid, chair of anesthesia and pain medicine at Akron Children’s Hospital.
Opioid medications pose little risk of addiction if they are used as directed, Dr. Farid said.
Dr. Farid, director of the Pediatric Pain Center, explained that opioids target pain receptors in the brain – after surgery, for instance – and they are usually very effective. But when those pain receptors are saturated, or they shut down naturally as the injury heals, opioids work on other receptors in the brain that create a euphoria or high.
“It starts a cascade of chemical reactions in the brain that leads to addiction and dependence,” he said.
That’s why it’s key for patients to follow directions.
“If it says 1 pill every 4 to 6 hours, make sure it’s 1 pill every 4 to 6 hours, not 2 hours.”
That said, sometimes patients need more medication than prescribed. People have different pain thresholds, and doctors for the most part prescribe conservatively to manage pain. But if the prescribed medication isn’t working, talk to your child’s doctor about adjusting the dosage. Never give a child pain medication prescribed to you or someone else.
As opioid abuse and overdosing have reached crisis levels, parents and practitioners are concerned. Many doctors are now denying proper pain medication out of fear, Dr. Farid said. But it’s important to maintain a balanced perspective because undertreating pain can have undesirable consequences.
“If you keep them in pain, different circuits in the brain kick in with cycles of pain-reinforcing mechanisms, leading to intractable chronic pain,” he said.
In other words, pain signals between the brain and the injury may continue after the injury is healed.
With an eye toward striking the correct balance, Dr. Farid and Dr. Kerwyn Jones, chair of orthopedics, are composing new guidelines for orthopedic pain management. Orthopedic surgeons are among the top prescribers of opioid medications.
“We have an obligation to treat and help, yet to educate and protect,” Dr. Farid said.
Research shows education can have a significant impact on teen behaviors. A National Institute on Drug Abuse (NIDA) study of cigarette and marijuana use among 12th-grade students found that when perceived risk of harm goes up, usage goes down, and vice versa.
Since the NIDA began tracking data in 1975, cigarette smoking among the teens had declined to the lowest point by 2013. Meanwhile, marijuana use increased in recent years as perceptions of risk declined.
Dr. Farid advises parents to talk to children about opioids, risks of addiction and the overdose epidemic, whether they are on pain medication or not.