Adebiyi Babatope O, Birnie Kathryn A, Schmeling Heinrike
Section of Rheumatology, Department of Paediatrics, Alberta Children's Hospital, Cumming School of Medicine, University of Calgary, 28 Oki Drive NW, Calgary, AB T3B 6A8, Canada.
Departments of Anesthesiology, Perioperative, and Pain Medicine, Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, Canada.
Children (Basel). 2024 Nov 26;11(12):1424. doi: 10.3390/children11121424.
Juvenile idiopathic arthritis (JIA) is a chronic autoimmune condition in children that often requires long-term pain management, which can include opioid use. In the context of Canada's ongoing overdose crisis, youth with JIA face risks due to potential opioid dependency and exposure to toxic drug supplies. This commentary proposes an integrated approach combining chronic disease management with harm reduction strategies specifically tailored for JIA patients. By incorporating multidisciplinary care, opioid stewardship, and harm reduction measures, this approach aims to address the dual challenges of managing chronic pain and mitigating substance use risks. Key recommendations include the development of integrated care models, enhanced access to multidisciplinary services, allocation of resources for specialized pain management, research, and mental health support, and investment in harm reduction initiatives. Additionally, comprehensive training for healthcare providers on the intersection of chronic pain, substance use, and mental health is essential. This integrated strategy not only supports the medical and psychosocial needs of youth with JIA but also offers a model for addressing the broader challenges faced by vulnerable populations in the overdose crisis. Adopting these measures will help protect this at-risk group, improve their quality of life, and contribute to the overall public health response to the overdose epidemic.
青少年特发性关节炎（JIA）是一种儿童慢性自身免疫性疾病，通常需要长期的疼痛管理，这可能包括使用阿片类药物。在加拿大持续的药物过量危机背景下，患有JIA的青少年因潜在的阿片类药物依赖和接触有毒药物供应而面临风险。本评论提出了一种综合方法，将慢性病管理与专门为JIA患者量身定制的减少伤害策略相结合。通过纳入多学科护理、阿片类药物管理和减少伤害措施，该方法旨在应对管理慢性疼痛和减轻药物使用风险这两个双重挑战。主要建议包括制定综合护理模式、增加多学科服务的可及性、为专门的疼痛管理、研究和心理健康支持分配资源，以及对减少伤害举措进行投资。此外，对医疗保健提供者进行关于慢性疼痛、药物使用和心理健康交叉领域的全面培训至关重要。这种综合策略不仅支持患有JIA的青少年的医疗和心理社会需求，还为应对药物过量危机中弱势群体面临的更广泛挑战提供了一个模式。采取这些措施将有助于保护这个高危群体，提高他们的生活质量，并为应对药物过量流行的整体公共卫生反应做出贡献。
