Despite the evidence that the powerful narcotic codeine doesn’t work—and could be fatal—in children, doctors are prescribing the painkiller to hundreds of thousands of children in emergency rooms each year. Somewhere between 559,000 and 877,000 kids are getting the drug from doctors annually, according to a 10-year study published in Pediatrics, reports CBS News. From 2001 to 2010, the number of kids who ended with a codeine prescription after an ER visit dropped from 3.7 percent to 2.9 percent. Even though the decline is good news, doctors say it’s surprising it hasn’t decreased closer to zero, reports NBC News.
“Ultimately, we found an incredible number of prescriptions still occurring,” said Dr. Sunitha V. Kaiser, an assistant clinical professor of pediatrics at the University of California, San Francisco, who led the research. Kaiser says all doctors and parents should know there are safe, and more effective, alternatives to codeine for both coughs and pain.
“Codeine is a pro-drug, which means it’s converted into morphine by your liver,” Dr. Dyan Hes explains to CBS News. “In children, not all of the enzymes work the same. In anybody actually, the enzyme can have different levels of activity, so some children can ultra-metabolize this, which means they rapidly convert it to morphine and that can lead to respiratory suppression and eventually death.” Although it isn’t clear why doctors continue to prescribe codeine to kids, some suggest it could have to do with having adult ER doctors taking care of pediatrics patients.