Imagine your alarm ringing in the early morning. You reach over and hit the snooze button, but the buzzing won’t stop. In desperation, you unplug the clock, take out the batteries, even throw the darn thing against the wall—but defying all reason, the noise repeats endlessly. This is how Rachael Coakley, a psychologist at Boston Children’s Hospital, describes life with chronic pain: a broken alarm clock in the body, the pain constantly ringing out, with no purpose and no relief.
Thirty years ago, clinicians questioned whether or not infants could even feel pain, labeling an infant’s pain response as a “reflex.” Today, some studies using MRI scans suggest that babies may experience pain more intensely than adults. But while adults can choose from a plethora of pain pills to stop the metaphorical clock—Vicodin, Percocet, Dilaudid—the options for children are much more limited. Pediatric patients are far less likely to be prescribed narcotics; instead, they’re often given inadequate doses of analgesia, leaving their pain unresolved, often for months at a time.
Recognizing pain in children is one problem; managing it is another. With only 12 percent of clinical drug trials in the United States incorporating pediatric testing, doctors simply don’t know how to safely prescribe most medications to children, much less risky narcotics—which is why, when the FDA approved the use of OxyContin for children this past August, the news rocked the pediatric-pain world. For the first time, the agency was sanctioning an extended-release opioid pill for children as young as 11 years old.* On the one hand, a proven effective painkiller would finally be available for suffering children—but on the other hand, recent history suggests that the decision may harm some of the kids it’s meant to help.