What is Codeine?
Codeine is extracted from the opium poppy plant. It is an opioid analgesic (painreliever)
and also used for the treatment of cough. Codeine has limited analgesic effect when
compared to other opioids like morphine. Codeine has the effect of creating a euphoric
or calming state when used for a long time.
What is Codeine used for?
Codeine is used as;
• Analgesic (pain reliever)
• Anti-diarrheal agent
• Relief of a non-productive cough
How does codeine work as a cough suppressant?
Codeine works to relieve non-productive cough primarily via its action at central
receptors in the brain.
When does a codeine-containing cough syrup become harmful?
The medicinal benefits of a codeine- containing cough syrup can quickly become
harmful when it’s not taken as prescribed. Excess amounts, regular use or overuse
can cause codeine side effects, many of which can be dangerous and may affect the
brain in ways very similar to illegal drugs.
What are the Effects of Regular Use of Codeine-containing products?
Codeine
is an opiate, the same as is morphine and heroin, and the regular use of this drug will
cause physical, emotional or mental addiction Regular use of codeine- containing cough syrups are as dangerous as regular use of
morphine, heroin or any other opiate drug, with the only difference being that it might
take a longer period of continual use to become addicted. But once addicted, the
withdrawals and the road back to where one was before they started using codeine-
containing cough syrup is arduous and painful and to have successful outcomes, it
usually requires professional rehabilitation
What are the dangers of mixing codeine- containing cough syrups with other substances?
It is very dangerous to mix codeine- containing cough syrups with other drugs like
promethazine. Mostly, people who die from codeine-containing cough syrup overdose
mix it with multiple drugs and sometimes with alcohol. Like codeine, alcohol is also a
depressant and taking them at the same time can result in:
• Dangerous respiratory depression
• Brain damage
• Coma
• Death
Is codeine-containing cough syrup safe to be used in children?
NO. Codeine-containing cough syrups are not safe to be used in children. Children are
known to rapidly metabolize codeine into an overdose of morphine and therefore
experience severely slowed breathing rates, and may even stop breathing and die.
What are the effects associated with the abuse of codeine-containing cough syrups?
- The major side effects of codeine use are bloating, blurred vision, chills, cold clammy
skin, confusion, constipation, darkened urine, difficult or troubled breathing, dizziness,
faintness or lightheadedness when getting up suddenly from a lying or sitting position,
irregular pounding or racing heartbeat, weak pulse, feeling of warmth, fever,
indigestion, loss of appetite, nausea, no blood pressure or pulse, no breathing ,pains
in the stomach, side, or abdomen, possibly radiating to the back ,pale or blue lips,
fingernails or skin, redness of the face, neck, arms, and occasionally the upper chest,
shortness of breath, stopping of the heart, sweating, unconsciousness, unusual
tiredness or weakness, vomiting, wheezing, yellow eyes or skin.
What are the signs of overdose with codeine- containing cough syrups?
- Signs
of overdose with codeine- containing cough syrups are bluish lips or skin, change in
consciousness, chest pain or discomfort, constricted pupils (black part of the eye),
decreased awareness or responsiveness, extreme sleepiness or unusual drowsiness,
loss of consciousness, no blood pressure or pulse, severe sleepiness and slow or
irregular heartbeat. When these signs are witnessed, the victim should be rushed to
the emergency room.
How can you detect codeine-containing products misuse and dependence?
- Clients repeated requests for certain codeine containing products by name, their
refusal to consider other products. Such clients usually approach pharmacy staff with
well-rehearsed scripts and resort to visiting one facility to another, termed “pharmacy
hopping”, when they are denied sale of their desired product.
What are the signs of withdrawal symptoms from codeine-containing cough syrup?
- Early symptoms of withdrawal may include feeling irritable or anxious, trouble
sleeping, teary eyes, runny nose, sweating, yawning, muscle aches, and fast
heartbeat.
How can Pharmacists help reduce the risk of misuse of codeine-containing cough syrup?
- Pharmacists can help by removing codeine-containing cough syrup displayed at point
of sale, refusing or restricting the sale except by prescription and also by providing
information and making direct interventions through questioning.
What is the FDA doing concerning the abuse of codeine-containing cough syrup (CCS)?
- The FDA has:
1. Intensified nationwide public education at schools, market places, beaches,
transport terminals etc on the dangers associated with the abuse and misuse
of CCS.
2. Collaboration with the police and other law enforcement agencies to organize
swoops to restrict influx and arrest drug peddlers of unregistered products.
3. Organizing training workshops in the entire country for law enforcement
agencies and other stakeholders in drug control on the abuse and misuse of
CCS.
4. Increased stakeholder Collaboration with the Media, National Road Safety
Commission, NCCE, DVLA, GES, PSGH, Ghana National Over the Counter
Medicine Sellers Association, National Youth Authority, NACOB, GMA etc.
5. Strengthened surveillance at the points of entry to prevent influx of
unregistered drugs
6. Strengthen follow-up inspections to monitor the distribution records of
importers and manufacturers of codeine products. 7. The Honorable Minister of Health has banned the importation and manufacture
of codeine-based cough syrups in Ghana.
References
For further clarification contact FDA on
- OFFICE LINES :-0302235100 / 0302233200 /
0544341222. o TOLL FREE :- 0800151000
(vodafone/Airtel) o Website: http://fdaghana.gov.gh o
Twitter: http://ghfda@gh_fda
o Facebook: Food and Drugs Authority-GH o
Email: fda@fdaghana.gov.gh o Whatsap Page 4 of 4
Version 4: 10th August, 2018
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