Codeine is well-known for its over-the-counter use in treating coughs and associated pain in children. A new report, however, casts serious doubts on its efficacy and safety, and is turning the medical community against the prescription of the once-popular opiate.
The report was published by the American Academy of Pediatrics last month in the wake of a number of codeine-related deaths in children, many of which occurred after tonsillectomy. It comes a year after the Food and Drug Administration (FDA) announced that it had found “little evidence of benefit” when considering the use of codeine in the suppression of coughs in children. The announcement was made by a special advisory panel which had been set up to take a fresh look at usage of the drug.
One member of that panel was Dr. Randall Flick, director of Mayo Clinic Children’s Center. He declared that the report went much further than simply casting doubt on the drug’s efficacy:
“The report went significantly farther and recommended that labeling of codeine use be eliminated for all indications and that codeine be removed from the list of medications for over the counter use.”
Dr. Flick went on to say that codeine use raised genetic issues, which could potentially cause complications in some patients. Codeine doesn’t provide pain relief until it is converted into morphine by the body. However, due to genetic differences in each of us, this conversion happens at different rates in different people. In some people, it doesn’t occur at all. In such cases, children experience no pain relief despite having been administered the correct dosage of the drug.
Flick then went on to detail a list of possible alternative medications as alternatives to codeine. The list included other opioids which do not suffer from the same genetic complications associated with codeine, along with non-opioid painkillers such as ibuprofen and acetaminophen.