Updated 16 November 2016

The most abused over-the-counter drug in SA

Codeine, which is used in Broncleer cough syrup and said to be the most abused over-the-counter drug in South Africa, should be used with caution, says Health24 resident doctor, Dr Owen Wiese.

Broncleer cough syrup which is manufactured by Adcock Ingram Pharmaceuticals is being abused by people seeking a cheap high, this is according to 2015 report by eNCA's investigative current affairs show CheckPoint.

The syrup contains codeine which was said to be the most abused over-the-counter drug in South Africa, which is also one of the top 50 codeine selling countries in the world.

Codeine is also found in a range of other medications, including Myprodol and Mybulen, Benylin C, Syndol, AdcoDol, Tensodol, Sinutab C, and Sinumax Co amongst other products.

Read: Youth gets high on cough medicine

While Broncleer has been banned in Zimbabwe, it is very popular among Zimbabweans living in Gauteng, found journalist Mosibudi Ratlebjane who spoke to two self-confessed Broncleer addicts. They said the popular syrup can be bought on the streets too.

Ratlebjane also accompanied the Hawks on a bust in Germiston where they confiscated hundreds of boxes of the syrup. While the sting was underway, a woman drop by at the dispensary claiming that she was collecting Broncleer to the value of R100 000 for her brother.

CheckPoint reported that the owner of the depot purchased more than 200 00 units of Broncleer, estimated to be worth over R1.7 million, since July last year. He was subsequently charged for contravening the Medicines Related Substance Act.

Codeine converts into morphine

Health24 resident doctor, Dr Owen Wiese said codeine is an opioid medication used for the relief of mild to moderate pain and to suppress coughing. 

"Part of codeine is converted to morphine by a complicated enzyme process that happens mainly in the liver." 

Dr Wiese warned that abusing codeine, in whatever form, could be very detrimental to one’s health.

"Continuous use of codeine can lead to tolerance and eventually abuse of the medication when more of the drug is needed.
"Like other opioid medications, abuse can result in vomiting and nausea, constipation, drowsiness. In severe cases respiratory depression can occur," he said.

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In South Africa, patients are required to provide their personal details including ID numbers, when they purchase a range of popular over-the-counter medications containing codeine in South Africa.

Ahead of this move, Nicola Brink, a consultant to the Self-Medication Manufacturers Association of South Africa (SMASA), said in a statement at the time that it is difficult to regulate codiene as no national database exists.

She also cautioned that moving all medicine containing codeine to a higher schedule which would require a doctor’s prescription could have an adverse effect on the sale of certain brands of medication and will place a further burden on an already overburdened healthcare system if a patient must go to their doctor for pain, fever and cold and flu symptoms.

CheckPoint airs on eNCA Channel 403 at 21:30 every Tuesday.

Also read:

Coughing up blood: when should you be concerned?

That lingering cough could be bronchitis

Vaccinate pregnant moms to prevent whooping cough in babies

Image: Medicines from Shutterstock


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Professor Keertan Dheda has received several prestigious awards including the 2014 Oppenheimer Award, and has published over 160 peer-reviewed papers and holds 3 patents related to new TB diagnostic or infection control technologies. He serves on the editorial board of the journals PLoS One, the International Journal of Tuberculosis and Lung Disease, American Journal of Respiratory and Critical Medicine, Lancet Respiratory Diseases and Nature Scientific Reports, amongst others. Read his full biography at the University of Cape Town Lung Institute.

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