Doctors Are Still Prescribing Opioids to Kids After Taking Out Their Tonsils

“Part of the story here is how hard it is to change how doctors practice medicine.”

Neustockimages

In 2011, new national guidelines published by the American Academy of Otolaryngology recommended that doctors stop prescribing opioids to children getting their tonsils removed, urging doctors to opt for other painkillers such as ibuprofen instead. But a new study published this month in the journal JAMA Otolaryngology Head & Neck Surgery found that doctors were still prescribing opioids to 6 in 10 children across the US.

“If you thought that doctors just followed national guidelines, it might be surprising,” said one author of the study, Dr. Kao-Ping Chua of the University of Michigan. “Part of the story here is how hard it is to change how doctors practice medicine.”

Researchers analyzed the data from a large US private insurer, which shared the insurance claims of more than 15,000 children ages 1 to 18 who underwent tonsillectomies between April 1, 2016, and December 15, 2017. Even though randomized trials have shown that ibuprofen is just as effective as opioids in treating the pain after tonsils are removed, researchers found that doctors continued to prescribe them to children.

“Opioids are inherently risky drugs,” Dr. Chua said. “A small percentage of patients, regardless of whether they are children or adults, will overdose on opioids.”

At least one child overdosed after taking the prescribed opioids for tonsillectomy. Others might have experienced commonly associated side effects like constipation.

Even more serious, however, is that opioid prescriptions increase the risks not only for patients but for the people around them. The median post-tonsillectomy prescription was for eight days, according to the study. But it’s common for unused prescriptions to be left in unlocked medical cabinets, or even on countertops, and that increases the risks of a young child accidentally swallowing them, or adults selling them or taking them recreationally. “There’s all sorts of misuse-related behavior that ultimately makes the opioid not just a danger to the person that you’re prescribing it to,” he said, “but also to their close contacts.”

Different geographic regions of the US have disparities in prescription patterns. Researchers found that children in some regions were more likely to be prescribed opioids for the same procedure than children in others. These regions also had some of the highest opioid-involved overdose death rates in 2017.

“What that suggests is that local practice culture…plays a bigger role in whether you get an opioid prescription than whether you actually need it,” Dr. Chua said. “What we need to do is to make sure that regardless of where you live, we are only prescribing opioids when they are necessary.”

MORE HARD-HITTING JOURNALISM

In 2014, before Donald Trump announced his run for president, we knew we had to do something different to address the fundamental challenge facing journalism: how hard-hitting reporting that can hold the powerful accountable can survive as the bottom falls out of the news business.

Being a nonprofit, we started planning The Moment for Mother Jones, a special campaign to raise $25 million for key investments to make Mother Jones the strongest watchdog it can be. Five years later, readers have stepped up and contributed an astonishing $23 million in gifts and future pledges. This is an incredible statement from the Mother Jones community in the face of huge threats—both economic and political—against the free press.

Read more about The Moment and see what we've been able to accomplish thanks to readers' incredible generosity so far, and please join them today. Your gift will be matched dollar for dollar, up to $500,000 total, during this critical moment for journalism.

We Recommend

Latest

Sign up for our newsletters

Subscribe and we'll send Mother Jones straight to your inbox.

Get our award-winning magazine

Save big on a full year of investigations, ideas, and insights.

Subscribe

Support our journalism

Help Mother Jones' reporters dig deep with a tax-deductible donation.

Donate

We have a new comment system! We are now using Coral, from Vox Media, for comments on all new articles. We'd love your feedback.