Society for Pediatric Pain Medicine
Better Care for Children in Pain

For January's Question of the Month, Dr. Rita Agarwal teamed up with a parent of and advocate for children with hereditary pancreatitis and chronic or recurrent pain, Beth Larson-Steckler (https://www.childhoodpancreatitis.org/)

This question is based on composite patient experience and is not meant as a critique of healthcare professionals in pediatric pain management, but a reflection of lived experience of patients and their families. Many families with children with chronic pain live in areas with limited access to health care and attempting to get appropriate care for their children can be challenging. These families often rely on their PCP and have minimal access to specialists.

Question: My 13-year-old daughter has acute and chronic pain related to hereditary pancreatitis that was well controlled on a stable dose of opioids. Her pediatrician switched her medications to gabapentin because he was concerned about the risk of opioids. Since she started taking gabapentin, she is short with us, crabby and depressed. She is crying all the time and her pain is worse. I am very concerned, I‘d like to have her switched back but her doctor keeps saying it’s better than opioids. What should I do first?

A. Keep going, eventually her symptoms will improve
B. Ask your physician for a referral to a pediatric chronic pain program to explore multidisciplinary based approach to management.
C. Continue trialing other chronic pain medications, something will eventually work
D. Demand you child get put back on opioids

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