Cough syrups that contain codeine linctus will be banned under plans to crack down on people misusing the substance.
The mixtures will no longer be sold in chemists in the UK after leading health officials raised concerns that people are becoming addicted to the medicine.
Those containing the ingredients ‘codeine linctus’ now will be only available if a doctor has prescribed it, the UK medicines' regulator has ruled.
Codeine linctus – an opioid – can have major health consequences and can make users addicted.
The Medicines and Healthcare products Regulatory Agency (MHRA) has warned that people should not turn to the black market and buy codeine linctus from an unregistered website because the product ingredients could be dangerous.
MHRA chief safety officer Dr Alison Cave said: "Codeine addiction can be a gradual process.
"If you have been taking it for a long time and want to stop, you can talk to your healthcare provider and reduce the amount you take slowly."
What is codeine linctus?
Codeine linctus is an oral solution or syrup that contains the active ingredient codeine phosphate.
This is the ingredient that helps to stop a dry cough.
The consultation was launched back in the summer after multiple Yellow Card reports were made that codeine linctus is being used recreationally for its opioid effects, rather than for its intended use as a cough suppressant.
The MHRA said it had received 116 reports of recreational drug abuse, dependence, and/or withdrawal as a result of codeine medicines since 2018.
In addition, there were 277 serious and fatal adverse reactions to medicines with codeine in 2021 and 243 in 2022.
Speaking to Sky News, Dr Cave 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.”
What have experts said about codeine cough syrup?
Pharmacists have supported the move, stating that there is “insufficient robust evidence for the benefits of codeine linctus in treating coughs safely and appropriately”.
Professor Claire Anderson, president of the Royal Pharmaceutical Society, said in a statement: “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 per cent of people are genetically predisposed to opioid dependence, the role of codeine linctus in treating what is ultimately a self-limiting condition is questionable.”
What is purple drank?
Part of the reason for the ban is the concerns over dependency and the liquid being used for purposes it was not meant for.
There have been rising reports of drug abuse and dependence on codeine medicines over the past five years, which is the reason it will now only be available through prescription.
The MHRA says that as well as the oral solution being misused and used too often for coughs, it is also being used as an ingredient in a recreational drink, sometimes called 'purple drank'.
Purple drank is a recreational drug that is mixed into a drink, prepared by mixing prescription-grade cough or cold syrup containing codeine and promethazine with a soft drink.
Professor Anderson added, "This not only addresses concerns about the misuse and addictive potential of codeine linctus, but also underscores the importance of prioritising patient wellbeing.
"Community pharmacists and their teams will continue to provide expert advice on managing dry coughs, and guide people towards suitable treatments."
