In South Africa‚ codeine tablets are like smarties: all you need is a bit of cash and a store close by and you’re sorted.
No prescription is needed‚ and – unlike with illegal drugs – you can simply pop down to your local chemist for a fix.
According to a study just published in the South African Medical Journal‚ codeine addiction is on the rise‚ and yet the country lacks people who are specifically trained to treat it.
Codeine is broken down by the body into morphine which is a very strong painkiller from the opioid family of drugs.
According to Professor Charles Parry‚ lead researcher on the study which was headed by the SA Medical Research Council‚ “Misuse of and dependence on codeine-containing products is on the increase globally.”
The problem “does not only lie with over-the-counter products where they are available‚ but also with inappropriate prescribing of codeine-containing medications‚” he said.
While local figures were not available‚ stats released a few days ago in the United Kingdom showed that codeine prescriptions had doubled from 12-million to 24-million in a single decade.
Many codeine products had seen in an increase in prescription rising by a staggering 287% according to The Guardian‚ which reported on that statistics garnered from the UK’s National Health Service.
Anecdotal evidence from surveys suggest that in South Africa‚ cough syrups are the most commonly abused codeine-containing drugs.
“There appears to be a broad spread of individuals providing treatment for persons misusing or dependent on codeine‚” said Parry‚ “They have general training in the provision and management of opioid agonist treatment‚ but few have specifically been trained in the management of codeine-related misuse/dependence.”
The problems is made worse by addicts not seeking treatment for various reasons‚ including heavy denialism and seeing drug treatment centres as having such a negative stigma that they daren’t step inside.
Said Parry: “The main barriers to patients entering treatment were seen as denial of having a problem‚ not being ready for change‚ mental health problems‚ stigma associated with going to a drug treatment centre‚ not knowing where to access treatment‚ and affordability”.
The research team concluded that further investigation is needed but “consideration should be given to campaigns that highlight that anyone can become dependent on codeine products used in the long term or excessively”.
And‚ anyone literally means anyone – from the stay-at-home seeking relief for headaches‚ to patients being given heavy-handed scripts from doctors‚ to pupils with dodgy contents in their juice bottles.
Last year‚ Plumstead High School principal Craig George told The Times that pupils were using soft-drink bottles to disguise their concoction of codeine syrup laced with disprin and crushed sweets to get an instant high.
“We started observing the appearance of cough mixture bottles‚ not only at my school but other schools as well‚” said George. He also noticed pupils carrying their own soft-drink bottles to school‚ rather than buying from the tuck shop.