Intoxication and addiction doctors warn against the administration of codeine cough syrup

Children and adolescents should be protected from codeine
Doctors warn against the use of drugs with codeine. According to the experts, analgesics with codeine are not suitable for the treatment of children under twelve years. Now an incident with a 14-year-old girl confirmed this warning. The teenage girl was seriously ill after taking painkillers with codeine. The current case had been published in the journal "BMJ Case Reports".
Codein medicines have long been accused of being ineffective and at increased risk of causing intoxication and addiction. Later, experts said that these allegations were unjustified. Now, the case of a fourteen-year-old girl made it clear that codein drugs should not be used to treat teens or small children. The girl was confused for days and suffered from serious side effects.

For children no codeine cough syrup! Picture: photophonie - fotolia

Girl experiences memory loss and sleeps through codeine twenty hours a day
In a fourteen-year-old teenager, an over-the-counter painkiller with codeine would have created acute confusion, physicians report in their investigation. So far, there have been no published reports of such effects on minors. Many parents still give their children codeine products today, despite concerns from regulators. This could be because "some parents are still convinced of the strong and fast analgesic effect," said medical professionals from Ireland. The girl was treated for five days in a hospital, the teenager was extremely confused and even suffered from memory loss. She slept about twenty hours a day, had a reduced attention span, and suffered from intermittent headaches.

Never take codeine for more than three days
The child's parents had told the doctors that, among other things, their fourteen-year-old child was mistakenly convinced that she had taken a shower, even though she did not. While the girl did her homework, she also changed the language unconsciously. The teenager had been suffering from flu-like symptoms for more than 15 days. She often missed school and was treated during this time with two or three tablespoons of codeine phosphate a day. Although the girl had not exceeded the recommended daily allowance, from three to six tablespoons, the child took the drug for an extended period of time. A maximum of three days is recommended, said the doctors in the investigation. For this reason, it was assumed that the fourteen-year-old had taken about 450-675mg of codeine instead of the maximum recommended amount of 270 mg.

Codeine can affect the central nervous system and respiration
The symptoms subsided after the child spent five days in the hospital. There was no codeine in the teenager's urine at this point. At a clinical follow-up, two weeks after her discharge, it was found that the fourteen-year-old was completely symptom-free again. The confused state is a relatively unusual complaint for Codeine. It was "urgently necessary to carry out further thorough investigations in this field," said the physicians involved. Codeine is known to often affect the central nervous system and respiration. In addition, the drug can cause a strong itching on the skin.

Codeine can trigger addiction in children
In April, the European Medicines Agency warned physicians not to use codeine in children and adolescents for treatment. The Agency reviewed international data on cough and other respiratory infections, including four deaths, with the involvement of codeine. The drug should be used for coughs and colds of minors only in special circumstances, the doctors said. Even older children and adolescents with breathing difficulties should not use codeine. Although there was no evidence of codeine addiction in this case, previous studies had suggested that children and especially vulnerable adults could develop an increased addictive potential for the drug, the authors of the "BMJ" article said. The combination of lack of efficacy, the risk of acute intoxication and dependence could make the use of over-the-counter drugs with codeine unjustified.

Persons under the age of 18 should completely abstain from codeine
Codeine is approved as a powerful medicine for pain relief. If parents have questions, they should go to their family doctor or pharmacist who can best advise them and recommend alternative treatments. Physicians are aware of the risks associated with prescribing codeine and are in line with current guidelines. They would generally not recommend codeine to children with codeine in children, said Professor Nigel Mathers of the Royal College of General Practitioners. It is also not advisable to use codeine medication if, for example, patients suffer from asthma. Codeine is an effective cough suppressant and available anywhere without a prescription. So if patients decide to take medicines containing codeine, they should read the leaflet and be sure to stick to the recommended dose. People under the age of 18 should not use any codeine medication for coughing, pharmacist Neal Patel warned.

Code: Risks are clear
There would be "limited evidence that codeine is effective in treating cough and cold in children," added the pharmacist. The risks outweigh the benefits for treating the symptoms of cough in this age group. Codeine-containing medicines for the treatment of pain or coughing in children are not suitable because of the possible serious side effects, explained Patel. Pharmacists generally advise that the drug should be taken with codeine only for three days and only at the recommended dose. A prolonged use could result in addiction to the drug. People with a cough that last longer than two weeks should consult a pharmacist or family doctor for advice.