Purdue Pharma recently announced it is conducting clinical trials on OxyContin in children. Immediately some have criticized, suggesting that the exposure to opioids at an early age will inevitably lead to addiction later in life. The larger issue that was missed is that there are times opioids are necessary for children. Children in intensive care units, emergency rooms, post operatively or in rehab often require strong analgesics. These are children with cancer, with severe burns, with sickle cell anemia or other conditions. It would be cruel and inhumane to leave children untreated who experience extraordinary amounts of pain. Of course opioids should not be the first line of therapy if an alternative is available, but they may be the only way to provide relief. So the question is not whether opioids should be used in children but rather how to use them safely when they are necessary. The only way we can know how to safely use medications in children is if they are studied in children. Science should inform patient safety.