LETTER: Codeine abuse a big problem

I wish to applaud the pharmacists’ association for taking the very responsible stand to curtail the abuse of codeine amongst our youth. This stand should be supported nationally by pharmacists and the medical profession and as well as the community.

The Western Cape branch of the South African Medical Association has recently written to the Medicines Control Council requesting the rescheduling of codeine containing substances because of the growing prevalence of codeine abuse amongst our youth.

Having dealt with a number of patients with codeine addiction I have learnt that many patients are unaware that they are addicted to codeine. They buy codeine containing tablets on regular basis with the erroneous belief that they are treating their headaches. Some of them can be addicted to as many as 500 codeine containing tablets a month.

Codeine, being an opiate, can lead to severe headaches once it starts withdrawing because the brain is starving for the codeine. It is for this reason most people addicted to codeine would wake up with severe rebound headaches after their bedtime dose starts to withdraw. This leads to a poor quality of sleep; poor work performance; a feeling of irritability and in some case a feeling of depression.

People addicted to small doses of codeine tablets can be safely weaned off their codeine with intensive psycho-education. Patients with severe codeine addiction can be treated with safe opiod replacement therapies.

Parents are strongly urged to watch out for signs of addiction in their children. Some of the signs would be asking for extra pocket money, lying, becoming argumentative, grades dropping, truancy, large and unexplainable number empty codeine cough syrup bottles and empty packets of codeine tablets not just in the kitchen bin but in the bottom of big black wheelie bins.

Dr E.V. Rapiti, Email

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