Friday 24th November 2017

Codeine abuse in Zambia

Zambia like many developing countries in Africa is trying to move with the current trends both positively and negatively, this has been observed in many areas. Drug abuse and Drug addictions have not spared Zambia and generally there has been very little research and documentation in this area.

One of the substances abused and often goes unnoticed is a deadly mixture that constitutes a cough syrup that contains codeine, an opioid. This mixture is popularly known as ‘lean’ or purple juice, though it can go by so many other names such as sizzurp, dirty sprite, purple drank, purp or simply juice. The other ingredients to this mixture could be a drink like soda, sprite and alcohol.

This drink has been glorified by popular music artists such as Lil Wayne real name Dwayne Michael Carter Jr and often mentioned in songs such as ‘me and my drink’ by Lil Wayne and three 6 mafias ‘sipping on some syrup’. This has made it more attractive to young people especially teens. This usually goes unnoticed by parents because parents would typically look for alcohol signs. The drink has also been known to be abused by drivers especially truck drivers who abuse it mainly because of the euphoria and insomnia effects of the codeine.

Codeine is an opioid pain medication. It is used to treat mild to moderate pain and it has anti-tussive properties which makes it very useful in the suppression of coughs. The codeine mixture is often sipped until euphoria and dissociation from one’s body occur. The effects usually last for 2-6 hours. For an additive effect some users add another powerful drug called promethazine which when coadministered with opioids such as codeine causes euphoria.

On our Zambian market codeine is contained in cough mixtures which are sold as a prescription and pharmacy medicine, but with the emergence of unregistered drug stores coupled with weak regulations, the product finds its way to the youth. Some products on the market that include codeine are benylin with codeine, baxylyn with codeine and histnyl.

The danger of this mixture is that it can cause so many side effects that would include rough and raspy voice, uncontrolled eye movements, drowsiness, loss of balance, constipation, hallucinations. Prolonged use of the mixture has more serious side effects which are exaggerated if combined with alcohol and other recreational drugs. The effects would include weight gain, tooth decay, urinary tract infections, and fatal conditions like neuroleptic malignant syndrome, severe fever, muscle stiffness, addiction and dependency.

A number of people worldwide have been hospitalized and also died from the side effects of the juice. Rapper Lil Wayne who glorifies the juice was hospitalized after he suffered seizures which can be associated with side effects of the drugs in the mixture. Many young people in Zambia are also suffering from the adverse effects of the drugs but could go unnoticed or misdiagnosed due to the lack of attention often paid to the abuse.

We all have a role to play and participate to correct this bad habit that has very serious consequences. Parents should be very vigilant and notice the strange behavior and also the signs and symptoms in the children. Traffic officers should also be trained to identify the effects of the drink in public service vehicle drivers and truck drivers. Pharmacists should be in the forefront in making sure the product only goes to the right people and also take note of the would-be addicts. Doctors should be vigilant and notice the signs and symptoms of substance abuse and also prescribe the drug only to the people who really need it. The regulatory authority should also take a tougher stance on the distributors and outlets that handle the drugs. The community at large should help report suspicious behavior and help the young people involved. The adverse drug reactions can also be reported through an innovative phone application by the Zambia Medicines Regulatory Authority called ADRA.

By Scott Kaba Matafwali
The author is a Pharmacist and Staff Development Fellow at the Copperbelt University.

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