Tag: patient advocacy

I want to share something that not every parent or even every doctor knows. Codeine is a medication often used for mild to moderate pain. I have taken it myself, and some of my children were given it years ago. For us, it caused strong reactions like nausea and even hallucinations.

What I learned later changed everything.

What Parents Need to Know

Codeine is not active on its own. The body has to convert it into morphine using an enzyme called CYP2D6. Some people have a genetic variation that makes this enzyme work too fast.

These individuals are called ultra-rapid metabolizers. When they take codeine, their body can convert it into morphine very quickly and in higher amounts than expected.

This can lead to:

• Extreme sleepiness
• Breathing problems
• And in rare cases, death

Why This Matters for Ethiopian Children

Studies have shown that ultra-rapid metabolism is more common in certain populations, including individuals of Ethiopian descent.

That does not mean every Ethiopian child has this risk—but it does mean the likelihood is higher and because of this, it is incredibly important to:

• Inform your child’s doctor of their background
• Ask questions about medications
• Consider alternatives to codeine when possible

Our Personal Experience

When our son had surgery at age 7, he was prescribed Tylenol with codeine. I told the medical team he was Ethiopian and mentioned the risks. At first, they were unfamiliar with this information and to their credit, they stopped, researched, and listened.

That moment reinforced something important:

• Doctors are human. They don’t know everything.
• Parents are allowed and responsible to advocate.

What the FDA Says

The FDA now recommends:

• No codeine use in children under 12
• Caution or avoidance in older children with certain risk factors

This warning applies to all children, but for families with known genetic risk factors, the conversation becomes even more important.

What We Do Now

We personally choose to avoid codeine for our child and ensure it is clearly documented in his medical records. Also, we also plan to pursue genetic testing when appropriate, to better understand how his body processes medications.

Final Thoughts

This is not about fear. It is about awareness. You don’t have to panic
but you do need to ask questions, stay informed, and speak up.

Sometimes the difference between safe and unsafe care is simply what someone knows and what they don’t. If this is new information for you, I encourage you to talk with your doctor and make sure your child’s chart reflects any concerns.

Be wise. Be aware. Advocate.