American Academy of Pediatrics: Don’t Give your Kids Codeine

The American Academy of Pediatrics released a report last week warning about the dangers of using prescription codeine to treat pain in children.

The report titled “Codeine: Time to Say ‘No’” details how children metabolize codeine — an opioid commonly used in cough syrups and medications to treat colds and diarrhea — differently from adults, presenting additional dangers for children using the medication.

“Additional measures are needed to prevent future problems with the use of codeine in the pediatric population,” the report states. “Improved education of parents and more formal restrictions regarding its use in children, regardless of age, are necessary.”

Codeine, like any other opioid, can slow breathing to the point of death when used improperly – especially in children.

From 1965 to 2015, 24 children died and 64 suffered severe respiratory issues as a result of codeine use, according to data from the Adverse Event Reporting System. Of the children who died, 21 were less than 12 years old.

Codeine remains a widely prescribed medication for pediatric patients in spite of known risks.

A study by researchers at the FDA found codeine was prescribed to roughly 800,000 patients 11 years old or younger between 2007 and 2011, more than any other opioid examined in the study.

The report also noted that within the past five years, the World Health Organization, the U.S. Food and Drug Administration, the European Medicines Agency and Health Canada have all issued warnings about the potential dangers and adverse effects of using codeine to treat children.

Despite evidence from FDA studies that show codeine’s minimal effectiveness of treating children with acute illnesses and suppressing coughs, nonprescription over-the-counter medications containing codeine are available in 28 states and the District of Columbia.

Medications with codeine include Promethazine with codeine cough syrup, Robitussin-AC, Tylenol #3, Gelonida and a host of others.

Genetic Factors

Codeine affects individuals differently based on a number of genetic factors. Dr. Richard Besser, ABC News chief health and medical editor, warns that codeine use can be risky for certain individuals.

“Codeine itself has no effect. It has to go through the liver and be converted to morphine, a very strong drug,” Besser told Good Morning America during a recent appearance on the show. “Some people convert it very quickly and some very slowly, and if you convert a lot very quickly it can suppress your breathing and in some children be actually deadly.”

During the appearance, Besser also advised parents to ask doctors for alternative medications if their child is ever prescribed an opioid for treatment. Nonopioid medications such as ibuprofen are the suggested options for child pain management, according to the authors of the study.

Opioid Abuse Worldwide

Codeine has been identified as a drug of abuse in the United States and around the globe.

A survey on nonprescription codeine use conducted in Australia showed that over-the-counter codeine users reported taking doses higher than the recommended therapeutic amount, and codeine-dependent individuals reported higher incidences of family histories of substance dependence.

In 2015 a doubling of codeine-related deaths in Australia prompted the Therapeutic Goods Administration’s Advisory Committee on Medicines Scheduling to recommend making codeine products available by prescription only.

According to the U.S. Department of Health and Human Services, every day 78 people die in the United States from an opioid-related overdose, and 580 people initiate heroin use, often as a cost-effective way to keep up with their opioid addiction.



Medical Disclaimer: DrugRehab.com aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.

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