opinion: it's time to make pain management for children a national priority

nearly eight million canadians, including one out of five children, live with chronic pain.

by katie birnie, phd and samina ali, md

published nov 07, 2023

3 minute read

join the conversation

3 minute read

join the conversation

it's time to make pain management for children a national priority

in canada, two out of three children experience painful medical procedures without any pain management. getty images

every single child in canada experiences pain from medical procedures, starting within hours of being born. left untreated, this pain can negatively influence their lifelong relationship with illness and medical encounters, including avoidance of routine vaccinations and preventive health checks. nearly eight million canadians, including one out of five children, live with chronic pain, costing an estimated $40 billion per year. no one should experience preventable pain — particularly not children and youth, and especially not when simple solutions already exist.

this national pain awareness week, as the federal government works toward pharmacare legislation and as local governments and health authorities try to address critical workforce shortages in health care, we must all keep children’s health, and particularly pain care, top of mind.

pain management is a fundamental human right. yet, in canada, two out of three children experience painful medical procedures without any pain management.

despite a universal, publicly funded health-care system, canada has fallen behind globally in the quality of health care we provide to children on all fronts, ranking 30th of 41 wealthy countries for the mental and physical well-being of its children. worse, marginalized and racialized populations, including indigenous families and children with disabilities, are more likely to experience pain and less likely to receive treatment for it.

in the last few years, the failure to prioritize quality pediatric care has increased risks and harms to children — unacceptable increases in pediatric surgical wait-times, poor access to mental health care, and extended wait times for sub-optimal emergency care related to overcrowding.

quality pain care has suffered greatly, with shortages of basic, child-friendly pain medications, and pressures to push patients through resulting in less pain prevention and treatment options being used.

dealing with pain can be debilitating, overwhelming and emotionally and physically taxing for children and their families, but there is hope. prioritizing children’s pain benefits not only the health and well-being of children, but also benefits adults and the health system.

by relieving and avoiding unnecessary pain for children, we reduce opioid prescribing, long-term opioid use, non-prescription opioid use, and opioid use disorder among youth. making vaccines less painful in immunization clinics increases vaccine uptake — families are less fearful of needle pain and long-term needle phobia is reduced. properly treating pain from medical procedures and surgeries helps children recover faster, reduces complications, and builds trust in the health care that they will access over their lifetimes.

there are excellent strategies available to effectively prevent and manage children’s pain, yet many families and healthcare professionals can’t access them due to current government policies and health systems.

this year, as healthcare professionals and pain researchers, we helped create the world’s first national health standard for managing children’s pain in canada: a roadmap to improving access to better pain services for children and their families.

we must act now. policymakers and healthcare leaders must ensure that policies and practices at all levels of government and healthcare are bold and equitable and focus on pain care for children. we have provided the roadmap; let’s now steer them down the correct path.

health canada provides specific recommendations for policymakers to address the unique needs of children and youth when implementing national pharmacare and to effectively and equitably address our country’s current poor management of pain.

further, the health standard for pain management in children and youth under 19 years of age provides clear guidance on how hospitals and other health-care facilities — both in large cities and smaller communities — can achieve quality, equitable pain care.

federal policymakers can bolster these leading efforts to improve pain by ensuring pharmacare legislation is informed by diverse families and child pain experts. a combined approach of medication and physical and psychological strategies is the most effective means of managing all pain.

provincial and territorial policymakers must ensure adequate access to and public health funding for psychological and physical treatments for children and youth alongside pharmacare. medication alone cannot address pain and suffering.

generations of children have not received basic pain care that we already know works. it’s time, this national pain awareness week, for policymakers and health leaders to make children’s pain a priority.

katie birnie phd rpsych is a clinical psychologist, assistant professor in the departments of anesthesiology, perioperative and pain medicine, and community health sciences at university of calgary, and the associate scientific director of solutions for kids in pain (skip).

samina ali md is a practicing pediatric emergency physician at the stollery children’s hospital (edmonton, ab), a professor in the departments of pediatrics and emergency medicine at the university of alberta, a skip hub lead, and the chair-elect for pediatric emergency research canada