Codeine
Cough Syrup
CODEINE
COUGH SYRUP IS A MILD NARCOTIC analgesic (painkiller)
similar to but less potent than morphine. Codeine is relatively
more effective than morphine after being taken by mouth. It
is used mainly to relieve mild to moderate pain. It is also
an effective cough supressant and can be found as an ingredient
in many cough syrups and cold remedies. CODEINE COUGH
SYRUP acts as a cough supressant by depressing the
central pathways of the cough reflex in the brain.
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- Codeine
and other codeine-like drugs (narcotic drugs) can
cause constipation through its action of inhibiting or slowing down
gut movements.
- Through
this action, codeine is sometimes used a short-term measure to treat
diarrhoea.
- Codeine
consumption is also habit-forming and therefore can cause dependence.
- However,
when used for a short period of time and at the recommended dose,
addiction seldom occurs. Codeine can be
safely stopped as soon as relief of symptoms is achieved.
When taken at the recommended dose, its onset of action
occurs within 30 to 60 minutes and lasts for four to six hours. When
the recommended dose is exceeded, signs and symptoms of overdosage will
appear. These include slow or irregular breathing (respiratory depression),
severe drowsiness (central nervous system depression) or loss of consciousness.
CODEINE
COUGH SYRUP can cause drug
dependence when taken for prolonged periods and not at the recommended
doses. In Malaysia, codeine-based cough syrup
abuse is rampant among teenagers and drug addicts who take it
as a substitute to dadah.
- There
is an increasing trend in using cough syrups as a
substance of abuse.
- It was
reported in a local newspaper that cough syrups with
a codeine content of 9 mg per 5 ml of syrup is particularly sought
after.
- This
syrup is drunk by the bottle and at least one 60 ml to 100 ml bottle
a days is needed to give hallucinatory feelings.
These are mostly used by drug addicts who are unable
to get their regular fix. It is known to the public that there are a
number of ways by which codeine-containing cough syrup
is consumed or abused. In some cases, drug addicts are reported to have
often taken it as a spiked soft drink. The drink is then shared among
them. It is even said to be popular among school children.
There may need to be a nationwide drive to stop the
unregulated sale of cough mixtures with codeine. This
is necessary to prevent the problem from becoming a social menace. In
addiction to giving a "high," the easy availability of cough
mixtures could lead to addiction among youth.
Codeine-based
syrups can cause both psychological dependence
is the emotional craving for a drug. There is a need for the
drug to be present in the body so that the desired effect can
be obtained. If it is absent, it will result in undesirable
effects.
Physical dependence involves physiological changes to
the body. These include withdrawal symptoms (severe physical disturbances)
and development of tolerance to the drug's effects.
WITHDRAWAL REACTIONS
Symptoms Signs
Anxiety Coughing
Apprehension Restless behaviour
Craving for drug Rhinorrhoea
Feeling of weakness Sneezing
Chilliness Rise in body temperature
Insomnia Agitated behaviour
Headache Cold, clammy skin
Nausea Salivation
Anorexia Refusal to eat
Gastrointestinal discomfort Vomiting
Abdominal cramps Diarrhoea
Muscular aches & pains Tremor
Drug tolerance occurs as the body adapts to the actions
of a drug. Individuals can develop tolerance to many drugs and this
is very dangerous. Individuals who develop tolerance need larger and
larger doses to achieve the same original effects and therefore tend
to increase the dosage. This will only increase the risk of toxic effects
and dependence.
It must be remembered that regular use of a particular
drug does not make an individual drug-dependent. There are other factors
that must be taken into consideration. These include the characteristic
of the drug itself (whether it has a low, medium or high dependence
rating), the strength and frequency of doses and duration of use.
POSSIBLE SIDE-EFFECTS
Common Rare
Constipation
Nausea/Vomiting
Drowsiness
Dizziness
Agitation
Allergic reactions (eg. skin rashes)
Wheezing
Under normal circumstances, when a prescribed medication
is taken as recommended by the doctor or pharmacist, there is a minimal
risk of developing drug dependence. Spiritual, mental, emotional and
physical factors also contribute to the avoidance or development of
drug dependence. The potential of drug dependence increases when a drug
is taken for non-medical reasons, as in the case of codeine-based cough
syrups.
Figures obtained from the Selangor State Pharmacy Enforvement
Unit shows a dramatic increase in cough mixture seizures from the year
1994 to 1995, concurrent with the increase in unregulated sales of cough
remedies during the same period of time.
In view of this, the Ministry of Health had decided
to tighten some regulations by banning the import and manufacture of
cough mixture containing codeine in combination with ephedrine or psyedoephedrine
in Malaysia as of January 1 this year.
What the Law States
Most cough remedies that can be bought from over-the-counter are categorised
as Group C poison under the Poison Act 1952. The sale of group C poisons
must be recorded in a prescription book. The details recorded are:
The date on which the sale was made
The name of the poison sold and its active ingredients
The name and address of the person who bought the poison
The penalty for illegal sale is a maximum fine of RM5,000 or two years'
jail or both
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cough syrup is a natural and it simply involves
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treatment seems to work by killing the bacteria and viruses
that cause infection in the lungs.
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