Codeine frequently given to children in the ER, despite alternatives

Codeine, an opiate valued for its sedative and painkilling properties, is still given to children visiting hospital emergency rooms despite documented risks, says a new study by researchers at the Benioff Children's Hospital in San Francisco. Though often prescribed to adults as a cough suppressant, codeine isn't recommended for children, as the bodies of young people who are still developing can't properly process the drug -- rendering it ineffective and sometimes toxic. For a small percentage of children, codeine can slow function to dangerous rates. "Despite strong evidence against the use of codeine in children, the drug continues to be prescribed to large numbers of them each year," said Dr. Sunitha Kaiser, lead author of the new study and assistant clinical professor of pediatrics at Benioff Children's Hospital San Francisco. Using data from the National Hospital and Ambulatory Medical Care Survey, conducted by the National Center for Health Statistics, pediatric researchers at the University of California San Francisco determined that rates of codeine prescription to children were 2.9 percent in 2010 -- down from 3.7 percent in 2000. Kaiser and her colleagues say that's still too high, as codeine offers few benefits to children and presents significant risks. The study was published this week in the journal Pediatrics. "Many children are at risk of not getting any benefit from codeine, and we know there are safer, more effective alternatives available," Kaiser said. "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." The study found children outside the Northeast were more likely to be prescribed codeine, as were African American children and those covered by Medicaid. "Further research is needed to determine the reasons for these lower rates so we can reduce codeine prescriptions to all children," Kaiser added.