UK pharmacies take charge: Cough syrup only with prescription to curb addiction

UK pharmacies take charge: Cough syrup only with prescription to curb addiction

cough syrup

Widespread apprehension about addiction and potential health hazards has prompted a reassessment of the availability of cough syrup and codeine linctus as over-the-counter medications. The UK medicines safety regulator has been inundated with increasing reports of drug abuse and dependence on codeine-containing medicines, raising fears of misuse. As a result, there is a call for public opinions on reclassifying codeine linctus as a prescription-only medicine. Pharmacists share their worry about the risk of overdose associated with this widely used remedy.

Codeine linctus, an oral solution or syrup containing codeine phosphate, is commonly sold in pharmacies to provide relief from coughs. However, some individuals are exploiting its opioid effects, using it to feed an addiction to pain-relieving medications. The Medicines and Healthcare products Regulatory Agency (MHRA) highlights the need for stricter control over the availability of codeine linctus to tackle misuse.

Dr. Alison Cave, Chief Safety Officer of the MHRA, acknowledges the effectiveness of codeine linctus as a medicine but cautions against the major health consequences resulting from its misuse and abuse. Reports of misuse and criminal activity related to codeine have been rising in recent years, often fueled by social media promotion. Since 2018, the MHRA has received 116 reports of recreational drug abuse, dependence, and withdrawal associated with codeine medicines, including codeine linctus. Alarming numbers of serious and fatal adverse reactions have also been reported, with 277 in 2021, 243 in 2022, and 95 already this year.

In response to these concerns, the MHRA has initiated a consultation seeking perspectives from healthcare professionals and the public regarding the potential prescription-only status for codeine linctus. Pharmacists welcome this step, citing a lack of robust evidence supporting the safe use of codeine linctus for treating coughs.

Prof. Claire Anderson, President of the Royal Pharmaceutical Society, emphasizes the availability of alternative non-codeine-based products that can be used to treat dry coughs, which often resolve without intervention. Studies suggest that up to 60% of people worldwide may be prone to opioid dependence. Cough syrups have also made headlines in India due to a different reason, with certain Indian-made cough syrups being linked to deaths in The Gambia and Uzbekistan. As a precautionary measure, the Indian government has mandated sample testing for cough syrup manufacturers before exporting their products.

Codeine, a painkiller belonging to the opiate group of medicines, works by blocking pain signals in the central nervous system and the brain, offering relief and reducing stress caused by pain. However, its potential for addiction makes it necessary for doctors to advise patients on proper use and discontinuation if needed. Children under 12 should avoid codeine unless instructed otherwise. The public consultation on codeine linctus will continue until August 15, 2023.

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