David Brousseau, MD: Benefits of timely opioid dosing for SCD pain

Children with sickle cell disease (SCD) experiencing acute pain episodes may avoid hospitalization when opioids are administered promptly in the emergency department (ED), according to a recent multisite study published in JAMA Pediatrics and discussed further by study author David Brousseau, MD, MS, pediatrician-in-chief and director of Research at Nemours Children’s Health.^1,2

The analysis of more than 9,000 pediatric ED visits across 12 US-children’s hospitals showed that giving the first opioid dose within 60 minutes of arrival was associated with reduced odds of hospitalization. Outcomes improved further when the second dose followed within 30 to 60 minutes.¹

“The highest quality of care is to get that pain treatment quickly,” said Brousseau in a previous interview with Contemporary Pediatrics. “Timeliness isn’t just a nice thing. It actually changes the lives of these patients in the ED, and maybe in whether they get to go home.”²

In this follow-up discussion, Brousseau highlighted how the benefits of avoiding hospitalization extend beyond the clinical setting.

“Obviously, that means they’re going home feeling better right now. It’s difficult to be in the hospital. It’s disruptive to the child. It’s disruptive to the parent of the child,” he explained.

Children who are discharged rather than admitted may miss fewer school days, while parents may avoid lost workdays and family disruptions. Beyond academics and employment, being able to recover at home allows children to return more quickly to their daily routines in a familiar, supportive environment. Brousseau also noted potential effects before ED arrival. If patients and families believe their pain will be taken seriously and addressed rapidly, they may be more likely to seek timely emergency care when needed.

“The emergency department is just one more component of the care team to improve your quality of life and pain,” he said. “I want the ED to be seen as a place where you’re going to receive high-quality care, where the goal is to get you home so you can continue the quality of life you want at home.”

References:

1. Fitch J. Timing of opioids and hospitalizations for sickle cell disease pain. Contemporary Pediatrics. Published September 8, 2025. Accessed September 12, 2025. https://www.contemporarypediatrics.com/view/timing-of-opioids-and-hospitalizations-for-sickle-cell-disease-pain
2. Fitch J. David Brousseau, MD, highlights impact of timely opioid dosing in pediatric sickle cell pain. Contemporary Pediatrics. Published September 5, 2025. Accessed September 12, 2025. https://www.contemporarypediatrics.com/view/david-brousseau-md-highlights-impact-of-timely-opioid-dosing-in-pediatric-sickle-cell-pain