Popular medicine could become prescription-only due to addiction fears

18 July 2023 , 11:05

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Cough syrup could become prescription-only (Image: Getty Images/iStockphoto)

Health chiefs have warned that cough syrup could become prescription-only due to fears of addiction.

The Medicines and Healthcare products Regulatory Agency (MHRA) said there have been a rising number of reports of drug abuse and dependence on codeine medicines.

Codeine linctus is syrup that contains codeine phosphate and is used by people to ease the symptoms of a dry cough. But the regulator said that there have been "multiple" reports of it being taken just for its opioid effects.

It received 116 reports of recreational drug abuse, dependence and/or withdrawal due to codeine medicines, including linctus, since 2018.

There were 277 serious and fatal reactions to codeine medicines in 2021 and 243 last year. So far this year there have already been 95 cases.

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The MHRA is now listening to views up until August 15 on reclassifying codeine linctus to prescription-only, and so not available over the counter, with some pharmacists also having raised their concern about overdose risks.

“If reclassified as a prescription-only medicine, all strengths of codeine linctus will only be available upon presentation of a prescription,” stated the regulator.

And Dr Alison Cave, MHRA chief safety officer, warned how misuse of the syrup could cause “major health consequences”.

She said: “Codeine linctus is an effective medicine, but as it is an opioid, its misuse and abuse can have major health consequences.

"Every response received will help us to develop a broader view on whether codeine linctus should be restricted to prescription-only status.

"We want to hear from members of the public, health professionals and others who would be affected by this potential change so we can make a properly considered decision for the benefit of patients, carers, and healthcare professionals across the UK."

Pharmacists have welcomed the move to examine the issue more closely.

Professor Claire Anderson, President of the Royal Pharmaceutical Society, said: "We welcome the MHRA consulting in this area, to understand the impact of this potential change on pharmacists, pharmacy teams and the public.

"Medicines should maximise benefits to patient health with minimum risk. We believe there is insufficient robust evidence for the benefits of codeine linctus in treating coughs safely and appropriately. We also have significant concerns about its misuse and addictive potential, as well as the risk of overdose.

"There are many non-codeine based products available for the treatment of dry cough. With studies showing up to 60% of people are genetically predisposed to opioid dependence, the role of codeine linctus in treating what is ultimately a self-limiting condition is questionable."

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