Posts Tagged ‘pharmacology’

Codeine cough syrup abuse in Nagpur

October 23, 2011

I was quite disturbed when I had found an empty codeine cough syrup bottle lying in Reshimbag ground[1] a few months ago.  It was apparent from its overall appearance that it was gulped as a single dose, clearly for recreational use.  As a medical graduate, I know what codeine is, how dangerous are it’s side effects, and how addictive it can be!  Over the last few months, the number of such empty bottles lying there have significantly increased and you can find several bottles thrown there on any given day.

Opioid-containing cough syrup bottles found at Reshimbag Ground

Opioid cough syrup bottles at Reshimbag Ground

Codeine is an opioid drug, which is used for symptomatic treatment of pain, dry cough, or severe diarrhea.  It’s primarily an analgesic that also suppresses cough and causes constipation as a side effect.  It is used as a symptomatic treatment of a nonproductive dry cough where the cough is so harsh that it causes pain with continuous coughing, even vomiting with cough, or sometimes even a rib fracture with severe bout of cough.  It is never used with mild cough or the cough productive of sputum.

Codeine is a weak opioid as compared to morphine, but quite harmful on it own account.  Drug abusers use it for the temporary euphoria it gives, but it is addictive and can cause severe physical and mental side effects.  Codeine causes drowsiness, even confusion, and hampers the ability of an individual to perform complex actions needing coordination such as driving or operating heavy machinery.  The effects of codeine get even more severe if it is combined with alcohol or other benzodiazepine drugs; and the user–if driving or operating heavy machinery–can be a great harm to himself and others.  At higher doses, codeine can cause respiratory distress, which can be life-threatening.

Codeine is addictive.  It does not leave the abuser easily.  It causes severe withdrawal symptoms if attempted to quit suddenly, with severe physical symptoms–even greater than mental symptoms–acute appetite loss, constipation, shivering, and most importantly drowsiness.[2]

Codeine is a prescription drug and should be used only if really needed.  There are a lot many safe cough syrups available and codeine-containing stuffs should be reserved for only when they are really indicated.  The bottles found at Reshimbag Ground must apparently be bought from some nearby medical shop.  Such higher-than-average sale of an opioid agent must not go unnoticed by the authorities.  It is quite concerning that your youth can get such addictive opioid at just 68.20 rupees a bottle.

Easy availability of codeine can attract new users to experiment with it, and newbies can soon be habitual users.  It is too easy to get addicted; detox is too difficult.  We don’t have good detox facilities, and a complete detox would need at least a month’s inpatient stay in the hospital.  Hope the authorities would notice it soon and curb any unindicated/over-the-counter use of opioid drugs.

Notes:
1.  A well-known ground in Reshimbag, Nagpur, near Rashtriya Swayamsewak Sangha headquarters.
2.  See this personal experience by an addict on Yahoo Answers