Myths about paediatric palliative care

 

 Children do not feel pain 

This is a misconception and children do expereince pain, therefore adequate relief from pain should be provided.

 

Children will become addicted to opioids

 

Some prescribers are reluctant in prescribing opioid for children which may be due to a lack of experience in using strong opioids, pressure exerted by parents or fear of using certain drugs off label. Therefore prescribers may feel an extra sense of responsibility in using such medications.

 

However, opioids used correctly do not cause addiction and on the contrary if inadequate pain relief is provided, this increases risks of pseudoaddiction. This is where the child becomes very concerned when they will get the next dose of painkiller in the hope that it will help relieve the pain.

 

It is important to explain to the parents that physical dependence and tolerance are not the same as drug addiction. Drug addiction is where the person feels compelled to take the drug and will deteriorate after withdrawal, whereas physical dependence and tolerance are normal side effects from drugs.

Although tolerance to the drug may inevitably occur in those with severe pain i.e. requiring higher and higher doses over time. However, patients are entitled to pain relief as long as they do not experience side effects associated with a certain dose i.e. respiratory depression or toxicity.