2014-05-12

Time to Stop Using Codeine, Really

Time to Stop Using Codeine, Really

We just received the May issue of Pediatrics, the top journal in pediatric medicine, and Dr. Alan Woolf, who is one of our nation's most respected authorities on the impact of drugs in children, published a definitive statement against using codeine to treat coughing.

http://pediatrics.aappublications.org/content/133/5/e1354.full.pdf+html?nfstatus=200&nftoken=8b07d062-ad2b-4f1f-ba88-218c6b251ad1&nfstatusdescription=SUCCESS%3a+Login+worked

Dr. Woolfe presents two reasons:

1.  Codeine does not work for coughs.   It does not reduce the severity or duration of coughs.  Plain English:  it does not work.

2.  Codeine can cause very serious side effects.  About 29% of people metabolize codeine so rapidly they are at risk for sudden jumps in opiate levels that can stop breathing and cause other dangerous hazards.
Many people who take codeine can experience severe nausea and allergic reactions as well.  About 2000 children in 2011 suffered toxic ingestions from codeine and codeine-containing products.   Plain English: it is not safe.

Dr. Woolfe notes that at Boston Children's, codeine containing products are now no longer available.  

That makes sense to us.  Why use a drug that does not work and can cause real harm?

Our answer is, we shouldn't.

We frequently get calls asking for something that can at least reduce a cough.  We sympathize. Cough is one of the most terrible experiences a healthy child can have.

And, for many decades, it has been assumed that codeine is a powerful anti-cough medication.  When a cough is keeping someone up at night, or terribly miserable, doctors,  including us, have turned to codeine, or tylenol with codeine, as the powerful drug to stop the cough.

As we have been noting for several years, it turns out codeine does not work.

Now a leading expert has published his call to stop using it.   We agree.

Of course, the decision to no longer using codeine because it does not work and it can cause harm, makes sense no matter how bad the cough is.

To good health,
Dr. Lavin


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