Cough Syrup Containing Codeine: Problem and Solution

Cough Syrup Containing Codeine :Problem and Solution

The February issue of PRN8099 has highlighted the importance of “Total War Against Dadah’. According to the statistical reports from the National Drug Agency, among the ‘dadah’ commonly consumed by addicts is cough preparations containing codeine.


Codeine is chemically classified as an opiate. Both physical and psychological dependence can develop with chronic use of codeine, however potential for dependence is much less than that with morphine.

Tolerance to opiates develops very quickly and after a few weeks of regular use, doses must be increased to produce the same effect. Drug addicts will do anything to get more supply and this can lead to other social problems. When they enjoy the effects, they will continue using it and this leads to chronic use.

Upon discontinuation of codeine, addicts may experience withdrawal symptoms including anxiety, tremors, muscle spasms, sweating, rhinorrhea, and paranoid delusions. Most symptoms fade fairly quickly but sleeplessness and feelings of weakness may continue for some months.

Cough preparations containing codeine have long been used as a substitute for heroin since it is relatively cheaper and more readily available. Despite actions taken by the Drug Control Authority (DCA) to curb misuse and abuse of codeine, this problem still persist and addiction towards this drug is becoming rampant. At its 137th meeting held on 20th June 2002, the DCA decided to take the following steps for all liquid cough preparations containing codeine:

The registration of all these products will be canceled with effect from 31st December 2002 (As at 20 June 2002, 46 such products have been registered with the DCA).

The manufacture and sales of these products will be terminated on 1st January 2003.

Registration holders are given until the end of 2002 to finish off their existing stocks (At its 141st meeting on 18 November 2002, the DCA allowed an extended 6 months grace period until 30 June 2003)

There are other opiates alternatives for cough such as Pholcodine and Dextromethorphan. The DCA has already registered 6 products containing Pholcodine in the form of syrup and linctus. However, being opiates, there is still a potential for them being abused.

Dextromethorphan was initially thought to lack addictive properties and the potential for abuse. However, psychological dependence (not physical) has been demonstrated, and the drug has been abused for its euphoric effects. Cases of overdose of dextromethorphan among teenagers already have been detected.

After withdrawing codeine-containing cough preparations, is there a possibility of illegal sales of these products? We have to ensure that this problem will not occur and we also have to get ready to overcome the problem if it happens. There is also a possibility of increase of abuse of other kind of substitute drugs like tablet containing codeine or other antitussive similar to it.

Health professionals and other enforcement authorities have to cooperate to ensure this enforcement effort is effective.

Source: PRN

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