ABUSE OF CODEINE-CONTAINING COUGH SYRUPS - A REPORT FROM INDIA

Aim. To study the socio-demographic and clinical profile of patients s eeking treatment for abuse of codeine-containing cough syrups (CCS). D esign. Observational; case series. Setting. An addiction clinic in Nor th India. Participants. Forty-six consecutive treatment-seeking patien ts of DSM-III-R-diagnosed dependence on CCS, from January 1994 to June 1995. Measurements. Semi-structured interview schedule for patients a nd their family covering socio-demographic and clinical variables. Fin dings. All patients were male. Many were young (mean age 27 years), wi th completed school education (85%) and from urban backgrounds (80%). The mean age of starting CCS use was 23 years. Initiated commonly thro ugh friends (89%) and often for curiosity (63%), 89% of the patients p rogressed to daily use of CCS in less than 6 months (54% in less than a month), and in quantities much higher than prescribed limits. Opioid -like withdrawal was reported by 92%. Concurrent use of other substanc es, psychiatric co-morbidity and HIV-related risk behaviour were prese nt in 72%, 24% and 45%, respectively. Most of the patients reported a 'stimulant' effect of CCS ('alert', 96%; 'more active: 94%). Conclusio ns. The combination of an opioid and a sympathomimetic agent in the CC S may cause a special, distinct euphoretic effect. This effect, along with the low price, easy availability and 'pure' preparation of CCS, m ay be responsible for the rapidly rising popularity of the CCS as drug s of abuse in India.