Codeine: SA’s over-the-counter addiction

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While no reliable statistics exist for codeine abuse in South Africa, it has become common enough that the Medical Research Council (MRC) is considering recommending that medications containing it be harder to buy.

Her children say it has turned her into a monster and have begged her to stop drinking a codeine-containing cough mixture, but the mother from Bethlehem says she cannot imagine her life without her daily doses of codeine.

Addiction to codeine, the drug found in a number of over-the-counter painkillers and cough mixtures, is real. And, say the woman’s family, it destroys lives.

But the mother, who did not want to be named, says she “can’t see myself surviving without codeine”.

The woman, who admits that she has even stolen from her children and her husband to be able to buy codeine-containing Bron Cleer. Nicknamed ‘bronco’ by users, the cough mixture is known as a “feel good” drug.

“I don’t think I can quit this medication now. My family doctor even suggested that I go to rehab but I have refused because I think if I stop now I will go crazy. It’s too late for me,” she says despondently.

According to the medication insert, if used correctly the syrup is reported to help relieve a cough, but if abused can be addictive and have a number of side effects from mental confusion to constipation and hallucinations.

Codeine nation

While no reliable statistics exist for codeine abuse in South Africa, it has become common enough that the Medical Research Council (MRC) is considering recommending that medications containing it be harder to buy. The MRC says over-the-counter and prescription pills are to blame for up to 20 percent of cases of drug abuse in South Africa.

Aware of the codeine dependence and misuse problem, the Codeine Care Initiative was formed in 2013 to help promote safe, responsible self-medication. It put a system in place which necessitates the name of the person buying codeine to be registered by a pharmacist in an attempt to help regulate the sale and distribution of medicines that contain this drug.

Codeine, says the initiative, is a narcotic that gives you a sense of calm and wellbeing, which makes it attractive even after pain or a cough has been relieved. As your body becomes used to codeine, increased doses are taken in order to achieve this same desired effect which is where the danger of addiction to and misuse of codeine comes in.

Over-the-counter medication not without risk

The Free State mother has been using Bron Cleer since 2000 when she lost her job. She said it helped her escape the pain of her life.[quote float= right]“I don’t think I can quit this medication now. My family doctor even suggested that I go to rehab but I have refused because I think if I stop now I will go crazy”

“It made me feel dizzy and I would doze off and forget my problems,” she tells OurHealth. “I just never stopped drinking the mixture since then.”

Her husband, children and even the family doctor have begged her to go to rehab but she says the fear of being without the codeine, which she believes helps her to survive, is too big.

The woman says that buying Bron Cleer is the first thing she thinks of when she gets money every month: “Sometimes when I don’t have it I take the risk of drinking any medication that I find in the house so that I can get dizzy.”

“I even get into arguments with my children because when I take the medication I forget everything,” she tells OurHealth. “Often I wake up in the morning and they will tell me how I was shouting at them and being mean for no reason.”

Her husband is at a loss at what to do. He has tried talking to his wife but to no avail and has also tried to get the family doctor intervene.

According to the family doctor, who could not be named, any medication containing codeine is “very dangerous and addictive”.

He said he had stopped giving the Free State mother the medication but then noticed that she was sending others on her behalf to get the Bron Cleer. Trying to get her to go to rehab has been futile.

The MRC is presently doing research into the extent of codeine use, misuse and dependence in South Africa, Ireland and the United Kingdom to understand the patterns of abuse with the aim of developing systems to prevent codeine abuse.

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