The government of Canada recommends that those under 18 years old should not use cough and cold remedies containing codeine, hydrocodone or normethadon. These are mostly prescription drugs, but some low-dose formulations including codeine are available without a prescription.
The health department says there is limited evidence that these cough and cold remedies are effective in children and adolescents.

For those under 18 years old, doctors should be asked to suggest alternatives to cough and cold products that contain opioids, says government. (iStock)
Manufacturers are asked to update safety information
And, even though a review did not find any strong link between these produce and opioid use disorder in this age group, it did find that the early use of opioids “may be a factor in problematic substance use later in life.”
Based on these two factors, the government decided to advise Canadians about the risks of the products. It is also asking manufacturers to update the safety information they provide on them.
The opioid crisis has reached such proportions in Canada that the government is promising to study the links between opioid use disorder and the use of products that contain opioids. It has also asked manufacturers to submit risk management plans to track and monitor risks.
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