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Meds and you

Updated 11 October 2019

Dangerous cough syrup 'cocktails': It's like making your own alcohol at home, say teenagers

Cough syrup contains addictive substances like codeine and alcohol, and if used in sufficient quantities, provides a euphoric feeling.

It’s not only booze and cigarettes our teenagers use to get high and take the edge off: South African teens are increasingly using “Lean” – a potent cocktail of over-the-counter cough syrup and soda/fruit juice.

Cough syrup contains addictive substances like codeine and alcohol, and if used in sufficient quantities, provides a euphoric feeling. Codeine can be obtained without a script and is often available at home. The drug is easily masked and blends in with the colour of cold-drink. 

Cough mixture cocktail 'trendy'

We spoke to more than 100 teenagers about their perceptions of “Lean”.

The South African teenagers, aged 14–17 years old, referred to Lean as “codeine”. Their purpose for drinking it was to “get drunk easily”.

It was thought of as a ‘trendy’ drug that was introduced to young people via social media platforms like Facebook and Youtube. Teenagers said that their peers would post about how to use this drug, and that lyrics in local and international rap and hip-hop music encourage ‘codeine’ use.

Cough syrups are generally designed to offer relief to persons who fall ill with, for example, the flu. However, misusing and abusing these medications is likely to have an impact on health and behaviour. Excessive use of alcohol and codeine has the potential to develop into full blown addiction.

Codeine-based products have sedative effects and using large quantities of codeine products may lead to fatal overdose. Studies have also shown that using alcohol during teenage years may increase the chances of adult alcohol use and even dependency. 

A note to parents

Teenagers learn about drug use through social media which means that the use of trendy drugs like codeine can increase rapidly. It is important for parents to be aware of these trendy drugs and their colloquial names, especially because teenagers can access them at home.

Although encouraging independence is important during teenage years, parents are encouraged to monitor how their children are using (prescribed or over-the-counter) cough medicines. Cough medicines generally come with specific instructions which should be strictly adhered to. Parents could also opt for alcohol- and codeine-free medications. 

A note to policy makers 

A critical issue that we found was that it was easy for teenagers to access and misuse over-the-counter cough medicines. The Children’s Act of 2005 indicates that teenagers who are 12 years and older can access medicines and treatment without parental knowledge or consent.

While this independence has many benefits, it may also enable young people to gain access to, and subsequently misuse, certain medications like codeine. This underscores the value of additional capacity considerations (e.g. ensuring sufficient understanding of risks and benefits of medication/treatment) as well as monitoring of over-the-counter medication sales more broadly.

Candice Groenewald is a post-doctoral researcher at the Centre of Excellence in Human Development, and her co-author Zaynab Essack from the Human Sciences Research Council

Image credit: iStock