A few decades ago, a healthy serving of ice cream and some Tylenol was the trick to recovering from a tonsillectomy—one of the most common children’s surgeries in the U.S., with more than 500,000 operations a year.
But a new study shows that as recently as two years ago—while the nation was in the grips of a pain-pill crisis—nearly 60 percent of kids were given and filled prescriptions for powerful and addictive opioids like oxycodone.
The University of Michigan study published Thursday by the Journal of the American Medical Association analyzed insurance claims for more than 15,000 children in 2016 and 2017.
It found that 45 percent of kids got prescriptions for hydrocodone bitartrate, the active opioid in Vicodin, while nearly 10 percent of children got oxycodone.
The researchers found some of the prescriptions clashed with regulatory advice: about 3 percent of kids filled prescriptions for codeine despite a 2013 FDA warning that it should not be given to patients under 18 after a tonsillectomy, and 0.7 percent of children were given tramadol in defiance of another FDA-mandated contraindication.
None of this surprises Amanda Thompson, 18, who was given Lortab, a brand-name version of hydrocodone, after she got her tonsils out three years ago and had a harrowing overdose experience.
The Utah teen told the Daily Beast she that remembers falling asleep in her parents’ bedroom and waking up to find paramedics looming over her. Seven doses of Narcan later, Thompson was revived and rushed to the hospital.
She says she was without oxygen for 10 to 15 minutes, and suffered brutal migraines for two years afterward.
“It breaks my heart to think of other children going through this,” she told The Daily Beast. “With me being the last one standing of these kids, I knew I had to say something.”
Today Thompson is pre-med at Utah Valley University. “I’m becoming a doctor to prevent things like this from happening again,” she said.
While the mean age in the study population was just under 8 years old, the researchers found that the older a child was, the more likely they were to receive and fill a post-opioid prescription.
The median prescription was for eight days worth of medication, longer than the seven-day restriction put in place by some states and insurance companies after the study period. A previous study showed that after recovering from tonsillectomies, the average child had 43.8 leftover opioid doses.
The study did note that overdoses were rare: There was only one report of a child in the study being hospitalized for taking too much, a rate “similar to that reported in a national study of adults prescribed opioids after surgical procedures.”
But the tangible benefits of taking the opioids were also limited; children who used them had just as many return visits to the doctor for trouble swallowing.
“The big picture for this is we need to reduce opioid prescriptions for children because they're incredibly dangerous,” said Dr. Kao-Ping Chua, one of the study authors and a pediatrician and health services researcher at the University of Michigan.
He noted that the study only examined prescriptions that had been filled, meaning doctors prescribed the drugs to even more than 60 percent of children post-tonsillectomy.
“People don't think of opioid overdoses as happening to kids. They think of adults overdosing. But children are prescribed them too, and we need to reduce exposure when possible,” said Chua, pointing out that randomized trials have shown ibuprofen is just as good for relieving post-tonsillectomy pain as opioids.
The study authors noted that their research could not measure the severity of the pain, the surgical technique or family attitudes towards opioids. Some of the children may have gotten prescriptions and not taken them to due to family attitudes and some parents may have paid for their children’s prescriptions out of pocket.