Codeine cough syrup abuse prompts ban on UK sales

Cough syrups containing codeine linctus will no longer be sold in chemists in the UK because of concerns people are becoming addicted to the medicine.

Several brands will now be reclassified and only available with a prescription following an assessment by a doctor, the UK medicines' regulator says.

It warns the misuse and abuse of codeine linctus - an opioid - can have major health consequences.

Pharmacists said there were many alternatives for treating a dry cough.

The Royal Pharmaceutical Society recommends drinking plenty of liquids, having warm drinks with honey and lemon and asking your pharmacist about other suitable cough medicines and cough sweets.

The Medicines and Healthcare products Regulatory Agency (MHRA) warned people should not buy codeine linctus from an unregistered website because the product ingredients could be dangerous.

'Purple drank'

There have been rising reports of drug abuse and dependence on codeine medicines over the past five years.

The MHRA says the oral solution is being misused - as an ingredient in a recreational drink, sometimes called 'purple drank'.

Its website shows there were around 250 serious or fatal adverse reactions to medicines containing codeine in 2023, and the same number in 2022.

Doctors, independent experts and patients were asked to have their say in a consultation to reclassify the medicine, so that it could only be prescribed as a cough medicine to those who needed it.

Pharmacists who gave their views said they felt under pressure to provide the medicine to those who had become addicted to it.

"Codeine addiction can be a gradual process," said Dr Alison Cave, MHRA chief safety officer.

"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."

Patient safety

The NHS website offers advice on addiction, as do supports groups such as Talk to Frank.

Dr Cave said patient safety was the regulator's "top priority" which is why it took the decision to reclassify codeine linctus.

Professor Claire Anderson, president of the Royal Pharmaceutical Society, welcomed the decision.

"This not only addresses concerns about the misuse and addictive potential of codeine linctus, but also underscores the importance of prioritising patient wellbeing," she said.

"Community pharmacists and their teams will continue to provide expert advice on managing dry coughs, and guide people towards suitable treatments."

Those brands which will only be available on prescription in the UK are:

• Codeine Linctus BP

• Bells Healthcare Codeine Linctus 15mg/5ml Oral Solution

• Care Codeine 15mg/5ml Oral Solution Sugar Free

• Galcodine Linctus

• Pulmo Bailly

What happens to codeine in the body?

• Codeine is a painkiller; it is part of a group of medicines called opiates

• It works in the central nervous system and the brain to block pain signals to the rest of the body

• It also reduces the anxiety and stress caused by pain

• It can be used when other painkillers have not worked

• It is possible to become addicted to codeine, so if you need to take it for more than a few weeks, your doctor will tell you how, and when, to stop taking it

• Children under 12 should not be given codeine unless advised otherwise