Got some kids' cough syrup with codeine stashed in the back of your medicine cabinet? The time has officially come to toss it.
In a new clinical report in the October 2016 issue of Pediatrics, "Codeine: Time to Say `No'," the American Academy of Pediatrics is now urging parents and health providers to stop giving codeine to children, and is additionally calling for restrictions on its use and more education about its risks for patients under age 18.
Why? Because despite a growing body of evidence that shows codeine can cause life-threatening or fatal reactions in children, the drug is still available in over-the-counter cough formulas in 28 states and the District of Columbia, and by prescription in all states. And it's still commonly prescribed to children after surgical procedures like tonsillectomies. In fact, more than 800,000 kids younger than 11 were prescribed codeine between 2007 and 2011.
Scary stuff. So why are so many doctors continuing to prescribe the drug to children if they know how dangerous it is? Lack of education, for one thing.
"I think that there just needs to be more education which is why we partnered with the AAP to write this article," the report's lead author, Joseph D. Tobias, M.D., told Parents.com. "For years, there was an unfounded belief that codeine was the safest opioid. It was thought that it had fewer side effects. It was also available in several formulations including liquid and tablets which made outpatient dosing easy."
Now we know better. Which is why the report describes potential alternatives—things like oxycodone, hydrocodone, oral morphine, and tramadol—but cautions that none of them are without risk. "Effective pain management for children remains challenging," Tobias explained. "because children's bodies process drugs differently than adults do."
So how, then, should a parent handle pain management for their child? The answer may lie in more effectively using other options that are currently available.
"The first step is the more efficient use of non-opioid agents including acetaminophen (Tylenol) and ibuprofen (Motrin, Advil)," Dr. Tobias told us. "These agents are very effective and can be combined to treat mild to moderate pain."
However, he noted that more research is still needed, as are additional measures to prevent future problems with the use of codeine in kids. "Improved education of parents and more formal restrictions regarding its use in children, regardless of age, are necessary," the authors concluded. "Additional clinical research must extend the understanding of the risks and benefits of both opioid and nonopioid alternatives for orally administered, effective agents for acute pain."