As prescription drug addiction is becoming more recognised as a real issue in the UK, cough syrup is still often considered a harmless medicine needed during cold winter months. But there is a darker side to this easy to obtain substance that often goes unnoticed — one that leads to substance abuse and addiction due to its habit-forming ingredients. And the powerful effects of cough syrup, which can lead to addiction, have long been an issue in the United States.
Recently, this danger has been highlighted by the UK Medicines and Healthcare Products Regulatory Agency (MHRA). They have suggested banning the sale of cough syrup containing codeine due to warnings that it may be habit forming and lead to addiction.
Codeine Addiction and Cough Syrup
At the heart of many cough medicines is a common yet problematic ingredient — codeine. This opiate, originally derived from the opium poppy, acts on the central nervous system to alleviate pain and reduce the chest and throat irritation that prompts coughing.
Although codeine is relatively mild as an opioid, its metabolisation in the liver transforms it into morphine, yielding a more potent impact on the body. The analgesic effects of codeine can also generate a euphoric “high” when consumed in substantial quantities, making cough syrup a cheap, easily accessible substance for recreational use and abuse.
We spoke with Danielle Byatt, a therapist for addiction therapy and Co-Founder of Step by Step Recovery Residential Rehab, for her opinion on the current situation with cough syrup addiction.
Danielle says: “While codeine-containing cough syrups can be bought over the counter, the levels of codeine in these products are significantly lower compared to prescription-only medicines. However, the risk of abuse and addiction while taking these types of cough syrups is still high.”
Addiction: Over-the-Counter vs Prescription Medication
The distinction between over-the-counter (OTC) and prescription medications is rooted in legal regulations. In the UK, medicines are categorised into three groups: prescription-only medication (POM), general sales list (GSL), and pharmacy medicines (P).
The “over-the-counter” label commonly refers to GSL and P medications, indicating products that do not require a prescription. Cough Syrup Addiction and Abuse
Cough syrup addiction can take root through two pathways: exceeding advised dosages and durations and using the syrup recreationally. Over time this can lead to addiction and dependence, which triggers physiological changes, causing the brain and central nervous system to rely on codeine to function normally.
Recreational users often consume excessive amounts of cough syrup to experience its side effects. This pattern of consumption, coupled with the common practice of mixing codeine in cough syrup with alcohol, amplifies the risks associated with abuse and long term potential health consequences. Those taking codeine-based cough syrup to treat a cough, but disregarding dosages and recommended durations are also at a high risk of developing dependence.
Cough Syrup and Overdose
When used excessively, codeine linctus in cough syrup can result in drowsiness, slow breathing, and respiratory failure. Additionally, it could make someone forget how much they’ve consumed, creating the possibility of an unintentional overdose.
It’s critical to call 999 if you think someone has consumed cough syrup and is having difficulty breathing, seems confused or has lost consciousness. Without early intervention death can occur due to respiratory failure.
Cough Syrup and Withdrawal Symptoms
So what happens when someone tries to stop abusing cough syrup? Withdrawal symptoms can be extremely unpleasant. Within 12 hours after the last dose, runny nose, chills, muscle aches, anxiety, and trouble sleeping may begin. Other possible symptoms include fever, nausea, vomiting, diarrhea, rapid breathing, and high blood pressure.
Psychological effects like suicidal thoughts in severe cases have also been reported.
Getting through withdrawal safely typically takes one to four weeks.
Timeline of Withdrawal
The severity and duration of withdrawal symptoms can vary from person to person and can be influenced by factors such as the duration of codeine use and the quantity taken.
As a general guide, a timeline of withdrawal symptoms to expect are:
- Onset: Acute codeine withdrawal symptoms can begin around 12 hours after the last use of codeine.
- Peak: The peak of withdrawal symptoms usually occurs around three to five days after cessation.
- Duration: Withdrawal symptoms can last from one to four weeks.
Seeking medical advice and professional support is highly recommended to manage withdrawal symptoms safely and effectively.
If you or someone you know is struggling with codeine addiction, reaching out to your GP, FRANK, or an addiction treatment rehab centre for the necessary guidance and support is the most important thing you can do today.