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Codeine use among children in the United States: a nationally representative study from 1996 to 2013

Margaret J Livingstone1, Cornelius B Groenewald1, Jennifer A Rabbitts1

  • 1Department of Anesthesiology and Pain Medicine, University of Washington School of Medicine, Seattle, WA, USA.

Paediatric Anaesthesia
|October 26, 2016
PubMed

Insights

Despite safety concerns, over a million children in the US used codeine in 2013. Safer alternatives are available, and healthcare providers should follow guidelines advising against pediatric codeine use.

Area of Science:

  • Pediatric pharmacology
  • Public health surveillance
  • Pain management

Background:

  • Codeine use in children raises safety concerns due to risks of respiratory depression and death.
  • International health agencies recommend restricting codeine use in pediatric populations.
  • The epidemiology of codeine utilization among children in the US was previously unknown.

Purpose of the Study:

  • To investigate the patterns of codeine use in children aged 0-17 years within the United States.
  • To analyze trends in pediatric codeine prescriptions from 1996 to 2013.

Main Methods:

  • Cross-sectional analysis of data from the Medical Expenditure Panel Survey (MEPS) from 1996 to 2013.
  • Examination of prevalence rates of codeine use in children over the study period.
  • Multivariable logistic regression to identify factors associated with codeine use, including patient demographics.

Main Results:

  • Codeine use among children remained relatively stable, with over 1 million children using it in 2013.
  • Increased odds of codeine use were observed in adolescents (12-17 years), non-Northeastern regions, and children with poor physical health.
  • Lower odds of codeine use were found in non-white children and those without insurance. Emergency physicians and dentists were primary prescribers, often for trauma-related pain.

Conclusions:

  • Although pediatric codeine use has seen a decline, it remains prevalent, with over a million children using it in 2013.
  • Healthcare providers need to be informed about guidelines recommending against codeine in children due to potential hazards.
  • Safer analgesic alternatives for treating pain in children are available and should be considered.
Abstract

Keywords:
adolescentsanalgesicschildnarcoticsopioidspediatrics

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