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The Opioid Debate—PRO

Opioids Have an Important Role in Pain Management in Children

Krane, Elliot J., MD

The Clinical Journal of Pain: June 2019 - Volume 35 - Issue 6 - p 468–472
doi: 10.1097/AJP.0000000000000700
Special Topic Series on Opioid Therapeutics and Concerns in Pediatrics

The increase in opioid-related deaths in the United States (and other countries) has prompted a national debate in medicine about the appropriateness of opioids for the treatment of acute and chronic pain, and specifically in children, if medical opioid use causes or increases the risk of opioid use disorder (OUD) later in life. Some in the medical community and in government advocate withholding opioids from children after an arbitrary number of days of treatment, regardless of diagnosis. Here, I argue that opioid experimentation and misuse is no more common in children and adolescents today than 2 or 3 decades ago, that there is no compelling evidence that appropriate medical use of opioids leads to OUD, and that the epidemic of inadequately treated pain in children remains the more compelling issue.

Departments of Anesthesiology, Perioperative & Pain Medicine and Pediatrics, Stanford University, Stanford, CA

The author declare no conflict of interest.

Reprints: Elliot J. Krane, MD, Department of Anesthesiology, 300 Pasteur Drive, Stanford, CA 94305 (e-mail:

Received January 13, 2019

Accepted January 15, 2019

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