The brochure Persisting pain in children for pharmacists 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 pharmacists.
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. Pharmacists 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 pharmacists 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 reference. Similar highlights brochures are published for physicians and nurses, and for
policymakers.