Dr. Kristin Woodward takes a look at this new study.
Half a million kids are prescribed codeine in the United States despite several warnings of codeine use in kids. A new study published in the Journal Pediatrics looked at Emergency Room visits between 2001-2010 in kids 3-17 years old. The study found over 570,000 kids received prescriptions for codeine each year for the treatment of cough suppression and as a painkiller.
Codeine is a narcotic pain medicine and cough suppressant. It is something called a “pro-drug.” Codeine requires the body to metabolize the medicine for it to be effective. About 8% of kids are ultra-metabolizers of the drug. This can lead to significant over-sedation and respiratory depression. One-third of kids do not metabolize the drug at all and therefore it is not effective. Due to the concerns of over-sedation and the variability seen in kids, several groups including the American Academy of Pediatrics have advised against the use of codeine in kids.
The study did show a slight decline over the ten-year period. It was also prescribed to more kids ages 8-12 years compared to kids 3-7 years old. Despite the decline many experts are concerned with the number of prescriptions. It is possible the use continues to decline.
Experts say all medicines have a risk/benefit profile. Parents should ask about side effects and alternatives. There are alternatives to codeine. Honey has been shown to be just as effective as codeine as a cough suppressant. (Honey should NOT be used in babies under one year.) Humidifiers are also helpful for persistent coughs. Ibuprofen is an excellent pain reliever in kids. If a child needs a stronger medication hydrocodone can be used. Always talk to your child’s pediatrician before using any medication.