More than 10 percent of all South Korean outpatients who are prescribed Codeine, an opiate used to treat pain and coughing, are young children aged 12 or under, a study revealed on Monday.

In a number of places, including the U.S and Europe, this particular drug has been advised not to be used by adolescents under 12 due to possible adverse effects.

The research, which was written and published by the Korea Food Forum, looked at the national health insurance records of some 1.37 million Koreans who were treated at medical institutions in 2011.

Out of a total of 6,298 Codeine prescriptions issued to Korean outpatients that year, 12.3 percent of prescriptions were given to young children aged 12 or under.

Throughout the year, almost all Codeine prescriptions to children were issued by small medical clinics. No general hospitals -- government-certified institutions with more than 500 patient beds -- issued Codeine prescriptions to any of their pediatric patients over the same period.

“We can conclude that health care professionals at small clinics are prescribing Codeine way too often to young children, and considering the possible adverse effects of the drug, this is very alarming,” the Korea Food Forum said in a statement.

Of the children prescribed with Codeine as outpatients, the largest number of them, 365, had sought medical help for acute bronchitis. The second largest number of them, 61, were prescribed the drug for asthma allergies.

“Codeine is an opiate and most general hospitals are very careful when they prescribe opiates for any medical condition because it can become a problem when they are inspected or evaluated by the government,” said a physician who wanted to be anonymous.

“But small clinics do not really have to care about the evaluations, as it does not affect their reputation as much. Codeine is known to be pretty effective when it comes to treating coughs, and it seems like doctors at small clinics often prescribe it to avoid having to deal with parents who complain that their children’s symptoms are not getting better.”

Since 2009, the American Academy of Pediatrics, the European Medicines Agency, the U.S. Food and Drug Administration, and the Canadian Ministry of Health have all issued warnings to discourage Codeine use in children under age 12.

The drug, which is converted into morphine in the body, can potentially trigger serious adverse effects including breathing difficulties and even death. It is believed that the process of the drug being converted into morphine happens more quickly in some patients, which can lead to high morphine levels in the blood and eventually serious breathing problems.

Last year, the European Medicines Agency reiterated that Codeine should not be used to treat coughing and cold in children younger than 12. It also advised against usage of the drug among those between 12 to 19 years old who have breathing problems, such as asthma.

The Korean government had also issued a warning to discourage the use of the drug in young children in 2013. “South Korea’s warning was issued much later than other countries, and we assume this is because Korea had been relying on data from developed nations for drug safety (instead of doing their own research),” the research paper said. The research paper did not mention whether or not the prescription rate of this particular drug had dropped in Korea after the warning was issued in 2013.

By Claire Lee (dyc@heraldcorp.com)