Tag Archives: flu

Codeine: Should we continue prescribing it?

 

Little boy not enjoying his cough medicine
From Mediconews by Satish

Flu season, it’s that time of the year where everyone around you is coughing, sniffling, or sneezing. Sadly, this time around I am once again one of those victims. For me, it all started out with a cough. And now what’s the one thing that people take when they have a bad cough? That’s right, cough syrup.

I took 1.5 tsps of something labelled as Ratio-Cotridin Expectorant. In the morning it did significantly reduce my cough but the drowsiness remained. Doing some quick research showed that the cough syrup in fact contained something that stuck out to me: codeine.

Codeine’s Molecular Structure
From Wikimedia by NEUROtiker

Codeine is an opiate which is known to act as a cough suppressant and narcotic analgesic. The most common side effect of codeine is drowsiness. However, codeine is also addictive and can cause dependence, which is why its circulation is strictly controlled in certain countries.

A study  published by the Norwegian Institute of Public Health in 2009 showed that the risk of being involved in a traffic accident with personal injury was two times as high in the period after having a codeine prescription dispensed.

Cough syrup aka “purple drank”
From coughsyrup.ecoffeeonline.com

Codeine has also been known to have varying results dependent on unpredictable genetic variations. There have been attempts to restrict age distribution and the amount that is able to be consumed. However, a simple search online shows that cough syrup with codeine is easily available. There are even tutorials that teach you how to make “purple drank” or “sizzurp” online, a recreational drug consisting mainly of codeine and Promethazine.

So should such a drug like codeine be so widely available to the public? It has been shown to contain significant risks and be pretty ineffective as an analgesic  according to an editorial by the Canadian Medical Association Journal. Their solution is to phase out codeine altogether and only use morphine. This may be a good alternative for a painkiller, but what about for a cough suppressant? Recent studies using the placebo effect show that codeine is not such a necessary ingredient in cough syrups anymore. Perhaps doctors should no longer consider prescribing codeine to patients with a bad cough altogether.

–Bonnie Tam