Kids getting codeine despite safety concerns

Little progress has been made toward adhering to national guidelines against the use of drugs containing codeine within hospital emergency department settings, despite concerns about prescribing them for children, a study finds.

Codeine prescriptions for young people between the ages of 3 and 17 decreased from 3.7% to 2.9% between 2001 and 2010, according to an analysis of emergency department visits published online Monday in the journal Pediatrics. But safety concerns over the use of codeine as well as debate over its effectiveness in children prompted the American Academy of Pediatrics to recommend against prescribing it in 1997 and again in 2006, so even the 2.9% level runs counter to those recommendations.

The number of emergency department codeine prescriptions ranged from 558,805 to 876,729 a year, the study found.

Children between ages 8 and 12 were the most likely group to get codeine prescribed, according to the study, while black children and kids covered by Medicaid were less likely to receive prescriptions.

Nurse practitioners and physician assistants were found to prescribe codeine at a slightly higher rate, at 3.9%, than physicians, who prescribed the drugs at a rate of 3.8%.

Concerns about codeine use for children center on findings that showed most children metabolized the opiate poorly, with up to one-third of the population of that age group having no signs of pain relief. Up to 8% of young people metabolize codeine too quickly, converting more than five to 30 times more of the drug than normal, increasing the risk of fatality.

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