Ban on codeine: Aftermath of war against cough syrup addiction

JOHN NWOKOCHA takes a postmortem look at the ban on codeine consumption, and wonders if the reform will change habit

Widespread syrup consumption Three months after the ban on codeine consumption, the obsession with the cough syrup appears to have continued judging from common place scenes showing youths consuming the drugs in public places across the country.
The codeine syrup is meant to a medication for relief of cough and cold, but a report on the widespread abuse of the medication, not only as cough suppressant but also for a feeling of relaxation and confidence, led to its ban.
An assistant director of information in the Ministry of Health, said the ban was a result of months of work by a committee, which submitted a report into the widespread abuse of the syrup.
It was a shocking revelation that an estimated three million bottles of codeine syrup were consumed every day in just two states, Kano and Jigawa.
In May, the NDLEA, in a single raid, in fighting this epidemic, seized 24,000 bottles of codeine syrup from a single lorry in Katsina.
Although the cough syrup is legal, it is against the law to sell it to people without a doctor’s prescription or those who do not have a pharmaceutical licence.
A popular pharmaceutical company boasted it could sell one million bottles of codeine in the black market in one week.
Before ban on codeine Prior to the ban on codeine cough syrup by the federal government, virtually everywhere you turned you found youths, even adults consuming codeine without prescription by a health expert.
The rate of consumption of the substance was alarming, so was the addiction to the syrup by youths across the country not minding the risk of health challenges from the syrup consumption.
Many observers of the trend had had to describe the problem as ‘addiction epidemic’.
Blueprint investigation showed the syrup was sold at the black market across the country and hugely patronised by young Nigerians, especially in the northern part of the country, who used the substance to get high.
However, those who take the syrup should know that Codeine is a pain killer but also an addictive opioid.
And if taken in excess, can cause schizophrenia and organ failure.
Ordinarily, codeine alone is a very bitter medicine which users may find uncomfortable to take.
But those addicted to the Codeine syrup commonly mixed it with soft drinks in order to have a sweet taste and consumed it.
The soothing taste may lure you to want to take it all the time.
Health implications Speaking on the health implications of codeine syrup consumption, the immediate past Chairman of Lagos State Association of Community Pharmacists, ACPN, Abiola PaulOzieh reportedly said, “Also, accidental ingestion of codeine can result in fatal overdose.
For addicts, it can lead to physiological harm.
Some addicts may end up having psychiatric problem while some may develop kidney or liver damage.
“Some addicts may develop seizure.
Somebody that is not having epilepsy before may begin to have seizure and high blood pressure”.
She said the effect may be so bad that abusers could even go into coma.
‘Never satisfied’ Explaining how it affects abusers, the ACPN Chairman said because it is a drug of addiction, as a person uses it and gets ‘high’, he will feel he is no longer in the world and sleep off.
“With that, it looks like his problems are solved only to wake up to realise that he is still in the world.
As a result, he is never satisfied and, with time, he demands for more.
That is what we call tolerance.
Then he begins to need higher doses.
“Then he moves from that level to what we call dependence.
Now he cannot do his job or normal activities without taking it.
And as he consumes the drug, it gives him euphoric feeling, a feeling of relaxation and confidence.
That is why you see that the people in entertainment industry are the first set of people into this habit of taking drugs because of the problem of facing the crowd.
In drug abuse, we have tolerance, dependent and addiction”.
While the codeine is imported, the syrup is made in Nigeria by more than 20 pharmaceutical companies The sweet taste may be the attraction to the deadly syrup.
But then, those still consuming the syrup despite the warning on the health risks need to be examined.
Sadly, reports say Nigerian youths now use it, just like cocaine, heroin or any other hard drug.
There is fear among watchers of the problem that Nigeria is gradually building a nation of drug addicts if not checked.
Dr Gafar Tunde, a health expert said, said the major implication was that those addicted to the drug will become desperate and may become violent and desperate.
“They would do anything to try to get it, and that would put pressure on the distribution system such that they would be willing to pay anything to have it”.
He explained: Codeine is often prescribed by doctors to assist with pains resulting from injury, trauma or illness.
It also have antitussive benefits, preventing harsh coughs, and very common in prescription cough syrups.
Studies have shown that the drug is also effective when used as an anti-diarrhea cure.
Despite these benefits, the product also has its disadvantages when wrongly used.
While blaming the indiscriminate use of the classified syrup on neglect of the distribution system by the federal government, Tunde said he supported the ban on codeine sale by unauthorized companies.
Stakeholders’ lament The reported cases of codeine addiction by the media prompted concerned Nigerians including the wife of President Muhammadu Buhari, Aisha Buhari to condemn the development.
In her response in an Instagram post, she said she was “deeply saddened” by the rise of the problem, especially in northern Nigeria, saying “I call on all security agencies, lawmakers, judiciary, drug manufacturers, civil society, regulators, teachers, parents, neighbours and you to take this as a personal war and halt the menace”.
Said an observer: “For long, government has turned its eyes the other way and things got this bad.
It is so unfortunate that until this revelation by the BBC, our government appeared to be doing little or nothing.” However, to achieve the objectives of the ban the government through its relevant agencies should ensure there is full implementation of the National Drug Distribution Guidelines.
Until this is done the ban to many, is like a war without end, watching the growing indiscriminate use of the syrup by young and old Nigerians.

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