Codeine Prescribed to Some Kids Despite Dangers

Codeine pain reliever frequently prescribed to children in emergency departments

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) Some medications that can help adults can be dangerous to the small, developing bodies of children. A new study found that one such medication may be used more than recommended in kids.

This new study focused on the use of codeine, a pain reliever, in children during emergency room visits.

The study found that despite warnings about its use in children, over half a million children were prescribed codeine each year during the 10-year course of the study.

"Ask a pharmacist if a medication is safe for your child."

Codeine is an opiate, or narcotic, medication that is used to relieve pain and sometimes used with other medications to treat coughs. Several organizations, including the American Academy of Pediatrics and the American College of Chest Physicians, advise against the medication's use in children, especially to treat a cough or cold.

“Many children are at risk of not getting any benefit from codeine, and we know there are safer, more effective alternatives available,” said the study's lead author, Sunitha Kaiser, MD, of the University of California, San Francisco's (UCSF) Benioff Children’s Hospital, in a UCSF press release.

“A small portion of children are at risk of fatal toxicity from codeine, mainly in situations that make them more vulnerable to the effects of high drug levels such as after a tonsillectomy,” explained Dr. Kaiser.

To explore how often codeine was prescribed to kids, Dr. Kaiser and team used data from the National Center for Health Statistics' Ambulatory Medical Care Survey for the years 2001 to 2010. The researchers focused on emergency room visits for children between the ages of 3 and 17 and examined how often codeine was prescribed.

In total, 56,375 of such visits were identified. Dr. Kaiser and team found a decrease in the rates of codeine prescriptions seen in these visits over the course of the study — from 3.7 percent of emergency room visits in 2001 down to 2.9 percent in 2010.

However, the researchers stressed that even with the decline, these numbers still represent a large amount of children who were prescribed codeine in the US. An estimated 559,000 to 877,000 codeine prescriptions were given each year to US children in emergency rooms.

The rates of codeine prescriptions had some variations based on demographic information and location. For example, children between the ages of 8 and 12 years old had a higher rate of codeine prescriptions, as did regions other than the northeastern US. Children with Medicaid and non-Hispanic black children had lower rates of codeine prescriptions.

Further research is needed to confirm these findings and explore the prescription of codeine to children in healthcare settings other than the emergency room.

This study was published April 21 in the journal Pediatrics. Funding for the study was provided by the National Institute for Children’s Health and Human Development. No conflicts of interest were reported.

Review Date: 
April 18, 2014
Last Updated:
April 21, 2014