Cough Mixture Abuse

Dr Ben Cheung

• Main Composition:– Codeine phosphate ( 可待因 )– Ephedrine hcl ( 麻黃素 )– Promethazine hcl ( 抗組織胺藥物 )– sugar

Harms of Cough Mixture Abuse

• Obesity

• Dental caries 蛀牙 • Mood disorders

• Suicide/ Aggression

• Psychosis

• Memory impairment and cognitive deficits

• Accidents: traffic, occupational

• Codeine can cause withdrawal symptoms

• Promethazine may cause drowsiness accidents

Ease of getting cough mixture

• Most of the cases had no problem getting cough mixture at all

• No registration of ID card was needed

• Some pharmacy stores provide a sheltered space for clients to take cough mixture

Clinical Data

• Among 58 consecutive cases attending KCH substance abuse assessment clinic:

• Mean age = 14.2• Common place of use:

– Video game centre (41%)– Drug store (33%)– Park (16%)– Under the staircase (8%)– Others e.g. Street (2%)

Clinical Data

• Need to register ID at time of purchase: 0%

• With psychotic symptoms:32%

• Had suicidal attempt: 11%

• Forensic record: 0%

• Time form 1st use to presentation: 67 months

Control of Cough Mixture

 

• According to the recent amendment of law, cough syrup containing not less than 0.2% of Codeine must be sold in pharmacies under the supervision of registered pharmacists and in their presence, with the support of prescriptions,