Cough Syrup Could Become Prescription-Only as Codeine Addiction Rises

Cough syrup, including codeine linctus, may no longer be accessible over the counter due to mounting concerns over its addictive nature and potential for serious health complications. The growing number of reported cases of drug abuse and dependence on codeine-based medicines has caught the attention of the UK's medicines safety regulator, and there’s growing impetus that it could become prescription-only.

Amid the rising tide of misuse, the Medicines and Healthcare products Regulatory Agency (MHRA) is considering reclassifying codeine linctus as a prescription-only medicine to combat the escalating problem of substance misuse.

Pharmacists have also expressed their apprehension regarding the overdose risk associated with codeine-based medications. Codeine linctus, an oral syrup containing codeine phosphate, is commonly sold in pharmacies as a remedy for coughs. However, a concerning trend has emerged where individuals are using it for its opioid effects, often to sustain a dependence on pain-relieving substances.

Dr. Alison Cave, Chief Safety Officer of the MHRA, explained, "Codeine linctus is an effective medicine, but as it is an opioid, its misuse and abuse can have major health consequences."

That’s seconded by the many rehab centres around the country that are seeing more and more people walk through their doors in need of codeine addiction and treatment. In fact, the issue has become more pronounced in recent years, with a surge in reports linking misuse and criminal activities to codeine, often propagated through social media platforms. Since 2018, the MHRA has received 116 reports related to recreational drug abuse, dependence, and withdrawal associated with codeine medicines, including codeine linctus.

Adverse reactions to medicines containing codeine have also surged, with 277 serious and fatal incidents recorded in 2021 and 243 in 2022. This year has already seen 95 such cases. Faced with these alarming statistics, the MHRA has initiated a consultation process to gather input from healthcare professionals and the general public on the potential transition to making this medicine available exclusively through GP prescriptions.

Pharmacists have welcomed this proposed shift, citing "insufficient robust evidence" supporting the safe use of codeine linctus for treating coughs. Prof Claire Anderson, President of the Royal Pharmaceutical Society, echoed their concerns, pointing out the risks associated with misuse, addiction, and overdose. She noted the existence of numerous non-codeine alternatives for managing dry coughs, which often resolve on their own.

Global studies suggest that up to 60% of individuals worldwide could be susceptible to opioid dependence. As discussions unfold regarding the potential reclassification of codeine-based cough syrup, it becomes evident that a multi-faceted approach is necessary to address the complexities of substance misuse and its impact on public health.

It’s likely this situation will continue on for a number of months and years, and it’s a decision that won’t be taken lightly by health officials, but the fact that has had to come on to their radar suggests that it’s a problem that isn’t going away any time soon.