Cape Town – Over-the-counter cough syrup is increasingly becoming one of several medications that South African teens are experimenting with.
This comes after hundreds of empty cough syrup bottles were found at a hangout on KZN's North Coast, according to a report.
A study conducted by the Human Sciences Research Council found that a growing number of youngsters are trying new “craze” drugs, including cheap and easily available over-the-counter-cough medications (OTCCM).
Candice Groenewald, chief research specialist at the Centre for Community Based Research, Human Sciences Research Council, said there were several factors that influenced cough syrup use in adolescents.
“In our study, adolescents were drawn to this substance because it is considered cheaper than alcohol and still gives the euphoric high that alcohol provides because it contains codeine or high quantities of alcohol. It is also easier to hide this substance in fizzy drinks or juice because it does not have a strong alcohol smell.
“Cough syrup use, or ‘lean’, ‘purple drank’, ‘sizzurp’ or ‘dirty sprite’ as it’s called, is also something that has been trending on social media and, as one of our participants explained, anything that is trending on Instagram is the one that we’d like’. The drug’s popularity and ‘glamorising’ on social media and in peer groups, along with the low cost, appears to further enhance its acceptability and ‘trendiness’. Finally, one of the biggest issues is that young people can walk into a pharmacy and purchase cough syrups that contain codeine or alcohol without an adult or without a script. This is extremely problematic. While there are many pharmacies that do not sell these substances to young people and who request proof of ID to record and register those who purchase medications with codeine, concerted efforts are needed to identify spaces that do not and to hold those individuals accountable for reckless practices.
“Excessive use of products containing codeine is problematic because it may lead to dependence on that substance and subsequently to withdrawal symptoms, including cravings and a preoccupation with using codeine products. The use of codeine-based cough syrups have been associated with severe deleterious outcomes like brain damage, the use of other illicit substances and increased risk to develop addiction. We thus need to speak back to the narratives and perspectives that young people have that it is okay to misuse or abuse this substance because it may have dangerous consequences. Research has shown that the early onset of substance use, like during adolescence, have long-term implications for adult health and well-being,” said Groenewald.
Professor Charles Parry of the South African Medical Research Council, who is director of the Alcohol, Tobacco and Other Drug Research Unit, said strategies needed to be implemented to prevent certain OTC medicines from being abused.
“We should think carefully before we campaign to have OTC medicines further up scheduled as this will just make it more difficult for people to access some medicines without a doctor’s prescription. That said, we do need to implement certain strategies to keep certain OTCs from being abused, such as putting medicines containing codeine or that in other ways have abuse potential behind the counter so that customers cannot see them and they have to ask for them specifically.
“For OTC medicines (this means) setting up online systems (registry) that check if the person has been sold a similar product within the past three days and if so, find out why they are purchasing the same thing again. If the answer is unsatisfactory or if the person keeps purchasing the product and the pharmacist believes it is being abused they should refuse the sale. This prevents ‘pharmacy hopping’.
“Another strategy could be increasing vigilance by pharmacists to find out why the person is requesting a product for example containing codeine when other pain medications might be better for muscle pain … Another strategy is to consider limiting the sale of products like cough medicines containing codeine to persons over the age of 18 and limiting it to one bottle,” said Parry.