Despite dangers, doctors continue to prescribe kids codeine

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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.

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