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

Fight disinformation: Sign up for the free Mother Jones Daily newsletter and follow the news that matters.

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.”

WE'LL BE BLUNT.

We have a considerable $390,000 gap in our online fundraising budget that we have to close by June 30. There is no wiggle room, we've already cut everything we can, and we urgently need more readers to pitch in—especially from this specific blurb you're reading right now.

We'll also be quite transparent and level-headed with you about this.

In "News Never Pays," our fearless CEO, Monika Bauerlein, connects the dots on several concerning media trends that, taken together, expose the fallacy behind the tragic state of journalism right now: That the marketplace will take care of providing the free and independent press citizens in a democracy need, and the Next New Thing to invest millions in will fix the problem. Bottom line: Journalism that serves the people needs the support of the people. That's the Next New Thing.

And it's what MoJo and our community of readers have been doing for 47 years now.

But staying afloat is harder than ever.

In "This Is Not a Crisis. It's The New Normal," we explain, as matter-of-factly as we can, what exactly our finances look like, why this moment is particularly urgent, and how we can best communicate that without screaming OMG PLEASE HELP over and over. We also touch on our history and how our nonprofit model makes Mother Jones different than most of the news out there: Letting us go deep, focus on underreported beats, and bring unique perspectives to the day's news.

You're here for reporting like that, not fundraising, but one cannot exist without the other, and it's vitally important that we hit our intimidating $390,000 number in online donations by June 30.

And we hope you might consider pitching in before moving on to whatever it is you're about to do next. It's going to be a nail-biter, and we really need to see donations from this specific ask coming in strong if we're going to get there.

payment methods

WE'LL BE BLUNT.

We have a considerable $390,000 gap in our online fundraising budget that we have to close by June 30. There is no wiggle room, we've already cut everything we can, and we urgently need more readers to pitch in—especially from this specific blurb you're reading right now.

We'll also be quite transparent and level-headed with you about this.

In "News Never Pays," our fearless CEO, Monika Bauerlein, connects the dots on several concerning media trends that, taken together, expose the fallacy behind the tragic state of journalism right now: That the marketplace will take care of providing the free and independent press citizens in a democracy need, and the Next New Thing to invest millions in will fix the problem. Bottom line: Journalism that serves the people needs the support of the people. That's the Next New Thing.

And it's what MoJo and our community of readers have been doing for 47 years now.

But staying afloat is harder than ever.

In "This Is Not a Crisis. It's The New Normal," we explain, as matter-of-factly as we can, what exactly our finances look like, why this moment is particularly urgent, and how we can best communicate that without screaming OMG PLEASE HELP over and over. We also touch on our history and how our nonprofit model makes Mother Jones different than most of the news out there: Letting us go deep, focus on underreported beats, and bring unique perspectives to the day's news.

You're here for reporting like that, not fundraising, but one cannot exist without the other, and it's vitally important that we hit our intimidating $390,000 number in online donations by June 30.

And we hope you might consider pitching in before moving on to whatever it is you're about to do next. It's going to be a nail-biter, and we really need to see donations from this specific ask coming in strong if we're going to get there.

payment methods

We Recommend

Latest

Sign up for our free newsletter

Subscribe to the Mother Jones Daily to have our top stories delivered directly 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