The brochure Persisting pain in children for physicians and nurses offers
concise information which is extracted from the WHO guidelines on the
pharmacological treatment of persisting pain in children with medical illnesses
unless otherwise stated.
These new WHO guidelines outline basic principles, clinical recommendations
and health system recommendations. This brochure highlights selected issues
which are essential for all health-care professionals who treat or care for
children with pain.
The WHO guidelines on the pharmacological treatment of persisting pain in
children with medical illnesses address the pharmacological treatment of
persisting pain, including cancer pain. As such, it replaces the previous
guidelines Cancer pain and palliative care in children, which exclusively
covered cancer pain. The new guidelines on persisting pain in children are the
first of a series of three guidelines documents on all types of pain in both
adults and children. The topics of the other two guidelines will be "persisting
pain in adults" and "acute pain". The basic principle of the guidelines is that
all patients with pain, including children, should be treated with either
pharmacological or non-pharmacological techniques, irrespective of whether the underlying cause can be identified.
The World Health Organization (WHO) estimates that around 5.7 billion people
live in countries where moderate and severe pain is not adequately treated. Data
from the International Narcotics Control Board (INCB) for 2009 show that more
than 90 percent of the global consumption of strong opioids occurred in
Australia, Canada, New Zealand, the United States of America, the United Kingdom and several other European
countries. This means that their availability was very limited in many countries
and regions. Over 80% of the world population will have insufficient analgesia.
Medicines for opioid analgesia, such as morphine, are subject to the
international drug control conventions and as a result, the focus has
historically been on prevention of misuse, dependence and diversion while medical access has been neglected. In
recent years, growing recognition of the legitimate use of these substances for
medical and scientific purposes has resulted in a shift in emphasis.
Mechanisms behind the impeded access to opioid analgesics and other
controlled medicines are of various natures. They include legal and policy
issues, and various educational issues at all levels, from patients and their
families to physicians, pharmacists and policy-makers. Doctors and nurses have
an important role to play in overcoming these barriers and expanding pain relief
treatment to all patients who need treatment.
This brochure provides background information on the treatment of pain in
children that can be helpful to doctors and nurses for ensuring adequate access
to pain treatment. For more detailed information and additional references we
refer to the formal guidelines document. In case of any discrepancy between this
brochure and the guidelines document, the guidelines document should be the
Similar highlights brochures are published for pharmacists and policy-makers.