Opioids are either synthetic or natural products from the poppy plant and are among the oldest and best-known pain medicines. There are many types, formulations and strengths of opioids.
Some parents have serious concerns about their children being given these opioids. Mostly, they worry about addiction and the possibility of an overdose. However, these drugs are very effective for dealing with moderate to severe pain. Follow the instructions of your child's health-care providers (including doctors, nurses and pharmacists) to minimize the risks associated with these medications.
The most commonly used opioids are morphine, oxycodone, hydromorphone and fentanyl. These pain medicines act within the central nervous system and the brain to provide pain relief.
Morphine and other opioids
Morphine and other opioid medicines such as fentanyl, oxycodone and hydromorphone are among the strongest pain relievers. They are usually prescribed for moderate to severe acute (short-term) pain and are important for managing pain following surgery, cancer pain, or in end-of-life settings. Other pain medicine can be used together with opioids. Morphine will usually be stopped first, before the other pain medicines, because it becomes less useful the longer it is used.
Side effects
There are side effects associated with opioids.
All opioids slow down the bowels and cause constipation and hard stools in about 50 per cent of people. This is the only side effect that tends not to improve over time. Your child may require the occasional or regular use of laxatives while taking opioids to help maintain regular bowel movements.
Opioids may also cause drowsiness, itchiness, nausea and vomiting. Some children may require additional medications to help control these side effects if they become intolerable.
Some children develop an urgency to pee, while others have difficulty peeing.
Opioids can also alter a child’s mood. For example, they might feel euphoric or very giddy, or they might feel a little down or teary. Some children may have vivid dreams or mild hallucinations and feel disoriented, although this is rare. Health-care professionals can provide guidance that will help to minimize the impact of these worrying side effects.
Uncommonly, and if given in too high a dose, opioids can cause low blood pressure, shallow breathing or a slow breathing rate. Children need to be carefully monitored for these effects as these are the most serious side effects of opioids. There are ways of medically managing serious side effects of opioids.
Should serious opioid-related side effects occur, the child may be given an antidote called naloxone that works quickly to reverse the effects of opioids. If your child is given opioids at home to manage severe pain, it is recommended to have a take-home naloxone kit. Speak to any community pharmacy about obtaining one, free of charge.
If your child is involved in their treatment, share with them the handout Five Questions to Ask About My Medicine. It will help them be better prepared when meeting with their health-care team.
Opioid checklist
SickKids has developed a checklist for parents and caregivers on the safe use and disposal of opioids. Always speak with your child's health-care team if you have any questions or concerns about your child's opioid prescription.