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Opioid Analgesic Prescription in French Children: A National Population-Based Study

Samira Choufi1, Simon Mounier1, Etienne Merlin1,2

  • 1Pédiatrie, CHU Clermont-Ferrand, F-63000 Clermont-Ferrand, France.

International Journal of Environmental Research and Public Health
|December 24, 2021
PubMed

Insights

Opioid analgesic prescriptions for French children significantly decreased from 2012 to 2018, following codeine restrictions. Tramadol use increased, while strong opioids remained infrequent, indicating reduced overall pediatric opioid use.

Area of Science:

  • Pediatric pharmacology
  • Public health
  • Pain management

Background:

  • Codeine use in children was restricted in 2013 and is contraindicated for those under 12.
  • Understanding trends in pediatric opioid analgesic prescriptions is crucial for public health and patient safety.

Purpose of the Study:

  • To analyze the evolution of opioid analgesic prescriptions in French children between 2012 and 2018.
  • To assess the impact of codeine restrictions on pediatric opioid prescribing patterns.

Main Methods:

  • Population-based study utilizing the SNIIRAM database (National System of Health Insurance Inter-Regime Information).
  • Analysis of opioid prescription trends in all French children from 2012 to 2018.
  • Comparison of prescription rates for different opioid classes, including codeine and tramadol.

Main Results:

  • Overall opioid prescriptions in French children decreased by approximately 63% from 2012 to 2018.
  • Codeine prescriptions saw a marked decline, while tramadol prescriptions increased by 171% during the study period.
  • Prescriptions for strong opioids remained a small proportion, with only 2.6 children per 10,000 receiving them in 2018.

Conclusions:

  • Restrictions on codeine use likely drove the significant reduction in pediatric opioid prescriptions in France.
  • Tramadol has emerged as a partial substitute for codeine in pediatric pain management.
  • The study suggests potential underuse of morphine and a general trend towards less frequent opioid utilization for pain in children.

Keywords:
analgesicscodeinemorphinepainpediatricstramadol

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