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Mental Health Tips > Cough Syrup

Cough Syrup
(Special thanks to Dr Ricky Tung for editing this article)

Cough syrup is commonly available in local pharmacies as over-the-counter flu remedy. It helps us to alleviate discomfort when suffering from flu, like cough and runny nose. Unfortunately, it is also a common choice of drug by substance abusers. It can be regarded as cough syrup abuse, when cough syrup is used not for the purpose of flu remedy, or using more than what being prescribed by doctor.

 
1. What does cough syrup contain ?
2. Why is cough syrup being misused by substance abuser ?
3. What does cough syrup abuse do to our health ?
4. Is cough mixture abuse illegal ?


1. What does cough syrup contain ?

The three common ingredients of cough syrup are:

  1. Codeine, a morphine-like substance that suppresses cough.
  2. Ephedrine, structurally similar to amphetamine, it can relieve airway obstruction and nasal congestion.
  3. Anti-histamine, commonly found in anti-allergy preparation, it can reduce nasal secretion and relieve runny nose.

However actual ingredient and its amount may varies in different preparations, some are even being illegally manufactured and they may contain dangerous adulterants.

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2. Why is cough syrup being misused by substance abuser ?

Cough syrup produces stimulant effects similar to amphetamine, because of the ephedrine it contains. One would experience euphoria, talkativeness and being over-energetic after abusing cough syrup, abusers may enjoy this feeling of boastfulness and boosted sociability.

Codeine, just as other morphine-like substances, for example heroin, would eventually produce physical and psychological dependent state after continuous use. To maintain the desirable effects or suppress unpleasant withdrawal symptoms, one has to keep using more and more cough syrup, even against his own will.

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3. What does cough syrup abuse do to our health ?

The commonest problem is poor dental hygiene. Cough syrup reduces saliva secretion, the syrup enhances growth of bacteria in the mouth, and together they cause severe dental caries and bad breath, significantly affecting one’s appearance and social functions.

Heavy use of cough syrup can lead to restlessness, irregular heartbeat, insomnia, irritability. In certain people who are prone to develop mental disorder, cough syrup abuse can produce an acute mental disorder with features similar to schizophrenia, such as hearing voice, illogical thought, confused speech and disorganized behaviour. In certain cases the mental abnormality would not cease by stopping cough syrup abuse alone, and these people have to be maintained with psychiatric medication for life.

Once dependence state is established, one would lose his control over cough syrup abuse and has to keep using it, no matter he is willing or not. Otherwise he has to endure weeks of distressing withdrawal symptoms including insomnia, restlessness and physical discomfort.

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4. Is cough mixture abuse illegal ?

Certain ingredients of cough syrup, for example codeine and dextromethorphan, are listed as “part I poison” in Hong Kong law. Even though cough syrup can be easily obtained from local pharmacies, sometimes without doctor’s prescription, illegal possession of cough syrup is in fact a criminal offense and liable to imprisonment.

Websites with relevant information / Reference

Government antidrug website

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