Experts advocate non-codeine based cough remedies
By ONYEMA JOHNSON Ogbonna
Tuesday, April 17 , 2012

Until the 18th century, raw opium served in diverse preparations, sometimes used as a folk medicine, taken with a beverage or swallowed as a solid in old China and environs. The progressive isolation of opium’s several active components brought about the need for improved selectivity and safety of the opiates-based pharmacopeia.

Codeine, an alkaloid analgesic drug and a derivative of opium, derived its name from the Greece word Kodeia meaning ‘poppy head’. For over three centuries, codeine remained the most widely used opiate in the manufacture of various healthcare products the world over, and probably the most commonly used opium derivative, according to reports by Agencies of the World Health Organisation – WHO. Chemically, as methyl ether of morphine, codeine has similar pharmacological effect as Cocaine and Heroin, though at a lesser degree because it is relatively less habit-forming, hence it is in the class as weak-opioid. Although, there however is little evidence to support its use to treat cough as it has been found to be no better than placebo in clinical trials. It is marketed in cough syrups with zero to a half-dozen other active ingredients and linctus. It is also available as inject-able for subcutaneous or intramuscular injection; intravenous injection can cause very serious reaction that can progress to anaphylaxis.

In an exclusive chat with The SUN, the visiting Jordan-Sweden (JOSWE) Medical Representative to Nigeria, Pharmacist Ahmed Kaddora, said that, ‘As you may well know, a lot of cough preparations contain codeine. There are relatively few benefits associated to the use of codeine as a combination to other therapeutics. Of course, one of its major problems is its addictive symptom, which is traceable to its morphine content. Other effect of codeine is Euphoria, which is the feeling of excitement induced by the abuse of codeine-based preparation and this can lead to depression. Codeine, as drug additive may be acceptable to some health experts, but you would agree with me that any drug with side effect is another story all together. For example, a potentially serious adverse drug reaction, as with other opioids, is respiratory depression and it is dose-related. For instance, as codeine is metabolised into morphine, the possibility of passing latent amount through breast milk to a baby is by no mince very high, in effect, fatally depressing the respiration of such infant’. Note complete recovery from opiate addiction requires years of social and psychological rehabilitation,’ the Pharmacist stated. Our source reiterated.

In yet another interactive session with The Sun, another Health Expert and Chief Executive Officer of a leading Pharmaceutical Company who preferred anonymity, had expressed concern over the alarming rate at which codeine-based therapeutics are abused with impunity in the country. This observation was made when he disclosed that, ‘Although, codeine-based preparation enjoys Over-The-Counter (OTC) status in Nigeria, it also has been discovered to be a veritable source of drug abuse by some exuberant youths and fun seekers who know full well of its morphine content. A scenario whereby some fun adventurers gulped substantial amount of codeine-based cough preparations in attempt to get HIGH is utterly despicable and incomprehensible’. The source stressed.‘It is disheartening to see how some manufacturers and dealers alike succeeded in catching into consumers erroneous believe that Codeine-Based cough remedies are more efficacious than their counterparts, the Non-Codeine Cough Preparations.

They apply all manner of marketing strategies to enjoy brisk sales at the expense of ignorant consumers, and this includes the astronomical hiking of product prices just to proof their point. For instance, facts abound that a pack of Non-Codeine Based Cough Preparation costs between N70 and N90 per pack, while its counterpart the Codeine-Based Cough Therapeutic sells at between N200 and N700 per pack at an average Nigerian Pharmacy’. The Health Expert reiterated.
Our source left us with a poser when he asked, ’If both products substitutes can serve same purpose, why then would any sane person opt for such highly priced product, knowing very well of its opium – morphine related content and eventual psychological implications?’ ‘I hope this will not make nonsense the fight against drug abuse in Nigeria’. He concluded.

A recent Newspaper report credited to Kano State Commander of the National Drug Law Enforcement Agency (NDLEA), Mr. Sumaila Eftan, was quoted to have said that, ‘cough syrups, especially the ones with codeine as major component, should be consumed cautiously and if possible consumed only when they are prescribed by a medical expert’. The NDLEA chief was reacting to latest statistical report on drug abuse in Kano state where some exuberant youths and fun seekers opted to abuse Codeine-based Cough Remedies to get HIGH. This no doubt shows a significant increasing in number of drug abusers that have found solace in codeine-based cough syrups. ‘They get themselves high by consuming large quantities of cough preparations.’ He reiterated.

However, observations have shown that there exist two keen divergent views. The first view supports the codeine-based cough preparation as a remedy to ameliorate chest-pain associated to dry-cough. While the second viewpoint is in favour of Non-Codeine Based therapeutics for its obvious after effects of drowsiness, euphoria, nausea, itching, vomiting, depression and withdrawal symptoms usually associated to codeine-based drugs.
Report says that the National Agency for Food and Drug Administration and Control (NAFDAC), has before now, drastically prune down the quantity of codeine allocated to drug manufacturers nationwide, and this we believe would eventually restrain the proliferation of codeine-based products in the country.
Hence, Healthy Living Enthusiasts are advocating for excellent cough preparations for all ages, with no side effects at affordable prices nationwide.

Complete recovery from opiate addiction requires years of social and psychological rehabilitation.’ The Pharmacist stated.

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