By the end of the day, nearly 100 more Americans will die from an opioid overdose. It’s a dire situation that The National Institute on Drug Abuse calls a devastating public health crisis.
But it’s not just adults who are falling victim. It might surprise you to know that every day in the United States, 2,500 kids ages 12 to 17 try a prescription pain reliever for the first time. They are perpetuating the cycle of abuse and running the risk of soon becoming yet another statistic in this tragic epidemic.
If we’re going to end this scourge, we must take a two-pronged approach: We must not only work harder to educate adults about the dangers of opioids and limit their availability, but we must also implement strategies to protect the next generation from ever becoming addicted. That will require collaboration between hospitals, outpatient clinics and the community.
Many people who end up addicted to opioids initially get the drugs from hospitals and medical providers, and that includes children. Acute and chronic pain management has become a major part of pediatric medicine. It is important to remember, however, that pediatric pain medicine is very different than adult pain medicine.
[See: 8 Questions to Ask Your Pharmacist.]
When an adult visits a pain doctor, for example, it is typically for a procedure. The patient may have low back pain and therefore receive an injection directly to the site of pain, which usually has a combination of numbing medicine as well as steroid to decrease inflammation. This interaction is very appropriate under the circumstance.
However, pediatric pain usually encompasses not only the patient, but everything that surrounds him or her. This may include family, friends, school and work — what we call the psychosocial context. Pain is so complex in children that many things can affect or worsen it and, vice versa, pain can make many things in a child’s life much worse.
In an effort to control pain and limit addiction, Nationwide Children’s Hospital became one of the first institutions in the world to have a designated Comprehensive Pain Services. The comprehensive approach best serves our patients pain management optimally and allows us to seamlessly transition patients between different areas of the hospital and phases of treatment.
Here, interventions like injections and opioid medications are extreme last resorts in the diagnosis and management of a pediatric pain and are not the standard of care.
In the past, for example, if a child were to undergo surgery, he or she might be hospitalized for several days following surgery and given systemic pain medication to control pain during recovery. But we have pioneered innovative pain-blocking techniques that use ultrasound machines and tiny catheters to direct pain medication only to the nerves affected during and after surgery.
The technique eliminates the need for opioids and, in a recent study of knee surgery cases at Nationwide Children’s Hospital, reduced admissions by 98 percent.
[See: 4 Opioid Drugs Parents Should Have on Their Radar.]
Our inpatient teams of practitioners perform approximately 200 nerve blocks per month to help minimize surgical-related pain. They also employ techniques such as biofeedback, aromatherapy and acupuncture.
Once a child is dismissed from the hospital, our outpatient Pain Clinics take a team approach to the long-term management of their pain. Physicians, psychologists, nurses, massage therapists, acupuncturists and social workers all team up to address as many aspects of a child’s life as possible, to help him or her manage pain and heal as quickly as possible.
We are also working with community leaders on an Opioid Safety Task Force to address the issue of addiction beyond hospital walls. We are defining best practices for opioid safe prescribing guidelines for pediatric practitioners, including limiting overprescribing of medications, especially unnecessary opioids.
We are also providing and encouraging the usage of lockboxes to many of our patients who have prescription pain medications at home. A recent study found that 2 out of 3 adults who have young children in the home admitted that they do not take the necessary steps to store pain medications safely. That means a child’s first encounter with abusing opioids may be less likely the result of getting them from a street dealer as it is simply taking them from the medicine cabinet at home.
The paradigm of pediatric pain medicine is continuing to evolve and shift. If we are going to break this tragic cycle of opioid abuse, addiction and death in this country, it is imperative that acknowledge the threat it poses to our children and employ comprehensive approaches to save them from this epidemic.
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Reducing Kids’ Access to Opioids originally appeared on usnews.com
