Despite dire warnings, kids still given codeine-containing meds
When children’s lives are at stake you would think regulators would move fast and furiously.
But where the use of codeine is concerned, it looks like the FDA is simply rearranging the deck chairs on the Titanic.
Now, a new report has come out saying that under no circumstances should any drugs containing codeine ever be given to children.
But with the med still being prescribed and available in almost 30 states without a prescription, it’s a case of too little, too late.
“No one should accept that a child dies after being prescribed codeine,” said a spokeswoman for a Toronto children’s hospital. “This is a totally unsafe practice.”
That expert was talking about a study that was published in the journal Pediatrics detailing the deaths of two children, a five- and four-year old, after receiving codeine for pain after surgery. The report told how dangerous the drug is for kids and why it should never be prescribed.
But that was four years ago. And unbelievably, kids have continued to be given this potential deadly med.
And even that wasn’t the first time experts heard about the risk.
Seven years ago the death of a toddler after having his tonsils removed was linked directly to codeine. And I’m sure there were many more tragedies disclosed before that one.
Despite all these warnings, however, the practice of giving codeine to children has gone on to this very day.
In 2013 the FDA finally limped into action and required a black-box warning on any drug containing codeine, saying that it should not be given to kids having their tonsils or adenoids removed. And that was that.
But obviously, it wasn’t enough.
The new report I mentioned, by Dr. Joseph Tobias, the head of anesthesiology at Nationwide Children’s Hospital in Columbus, Ohio, disclosed some shocking facts.
- Codeine-containing drugs are still widely prescribed for kids by ear/nose/throat doctors, followed by dentists and pediatricians.
- Despite the black-box warning the FDA required three years ago — one that says to never give codeine to children after tonsil/adenoid surgery — it’s still “commonly prescribed” after these procedures.
- Codeine can still be found in OTC cough medicines available at outpatient pharmacies in 28 states as well as the District of Columbia!
It’s the perfect storm for more tragedies to occur.
Most of the children who died as a result of being given codeine suffered from an overdose of morphine — what codeine is converted to in the body. And they didn’t get too much of the med, either — they all received “standard doses.”
But some children have a genetic quirk, making them what doctors call “ultra-rapid metabolizers.” That means their livers convert the codeine into morphine too fast, creating a deadly amount in their bloodstream.
You may be wondering how many kids are prone to this, and if you can find out if your child or grandchild is one of them.
Good question. And it’s one that can’t really be answered unless you go to the trouble and expense of having some extensive genetic testing done. Plus that, even kids who don’t have this genetic problem can be seriously harmed by the drug if they have any conditions that affect their breathing such as asthma or apnea.
But the most surprising take-away from all these codeine warnings over the years is that physicians continue prescribing it to kids.
As one expert said, “changing the habits of doctors is very difficult.”
And while the pain-relief options for kids are limited, OTCs such as ibuprofen or other NSAIDSs can be used as well as oxycodone in extreme cases.
But what should never, ever be given to a child is codeine. And that’s something all doctors should know by now.
Sources:
“Codeine not safe for kids, pediatricians warn” HealthDay, September 19, 2016, MedlinePlus, medlineplus.gov
