Six out of every 10 children that get their tonsils taken out receive prescription opioid painkillers after surgery, a new study found.
Those drugs may do nothing to keep kids from developing complications from the routine operation, the University of Michigan research team suggests.
Professional associations recommend that children be given non-opioid painkillers like aspirin or Tylenol, yet doctors are still doling out the drugs – often far more than a pediatric patient will need.
Not only does this offer little benefit to the nearly 300,000 children that get tonsillectomies a year, but leftover drugs sitting around a household can be the beginning of another family member’s addiction.
About 60 percent of children that get their tonsils removed are prescribed opioid painkillers, despite medical associations’ guidance that aspirin and Tylenol are sufficient, a study found
No one wants to see their child in pain after surgery, or otherwise, but over-medicating them is not the answer.
‘Our study suggests that many children receive opioid prescriptions after tonsillectomy and that the amount of opioids in these prescriptions may be excessive,’ said lead study author, Dr Kao-Ping Chua
Some pain is inevitable after a child gets their tonsils out.
Most may have throat and ear soreness for up to two weeks after the surgery.
But for kids this pain should be manageable with just some anti-inflammatory medication.
Plus plenty of cold fluids will both ease the pain and help children stay hydrated – a key part of their healing process.
Concerned parents tend to be of two minds when it comes to painkillers and their children, though: they recognize that the over-prescription of opioids is a problem, but they think they’re still the more effective way to manage their kids’ pain.
A recent survey found that only about a third of parents whose children had been prescribed opioids at some point had actually discussed alternatives – like Tylenol or steroids – with their doctors.
American Academy of Otolaryngology instructs doctors that, after a tonsillectomy, these milder painkillers are the recommended treatment for children.
But the new study, published in Jama Otolaryngology – Head and Neck Surgery, found that 60 percent of kids that get the procedure are not only prescribed these drugs, but that their parents filled and sometimes refilled them.
There were 15,793 children who’d undergone tonsillectomies included in the study, and most were prescribed six- to 10-days worth of opioid painkillers.
The researchers said that the number of pills was far greater than what an average patient will need.
In fact, a previous study found that when a child was prescribed 52 doses of an opioid, they wound up with an average of 44 leftover.
Those 44 pills are certainly enough for another household member to take, start developing a habit, and even to overdose on.
In fact, one child included in the new study did suffer an opioid overdose.
Risks were also higher for constipation among the children who were given opioids.
The strong pain relievers did not, however, do anything to reduce the likelihood of other complications.
Complications – most commonly trouble breathing and bleeding – are common with tonsillectomies, striking about one in five children that gets the procedure.
For this reason, many have speculated that the surgery may not be a worthwhile fix for breathing obstructions or recurrent infection. The rate of pediatric tonsillectomies has fallen drastically since the mid-1990s.
Doctors and parents a like tend to believe that pain management through opioids is more effective than through other drugs, and that if pain is better managed, the child is less likely to suffer complications.
But the numbers don’t bear that out.
According to the new study, it didn’t make any difference what children were prescribed – there were no greater risks that they came back to their doctor reporting a complication or looking for better pain management.
Nonsteroidal anti-inflammatory drugs (NSAIDs) like aspirin can block the blood from clotting as well as usual, raising concerns that taking them may cause excess bleeding.
This concern has sometimes steered doctors away from prescribing them to kids after tonsillectomies – when they’re prone to some bleeding any way – but the new study found this point mute.
Once again, children who were given opioids were at no lesser risk of bleeding than were kids who given less potent pain medications.
In other words, doctors could likely prescribe less opioid painkillers to fewer children, without fear that the rate of complications or complaints would climb.
‘To minimize the risks of opioids to children and their families, clinicians should rely on non-opioids when possible. When opioids are used, clinicians should aim to prescribe only the amount that patients need,’ said Dr Chua.
And when doctors do choose to prescribe opioids, they need to be sure that parents know to properly dispose of any leftover drugs at pharmacies, health clinics or police stations to keep their kids’ medications from fueling someone’s addiction.