In the past few months, authorities in Varanasi uncovered a major smuggling network involving codeine-based cough syrups. Thousands of bottles were being illegally transported to different states and neighboring countries under the names of fake pharmaceutical firms and medical stores. Many of these companies existed only on paper. They have been accused of selling cough syrup without licenses, hiding stock, and submitting forged documents. Several lakh bottles have been seized, and dozens of FIRs have been registered.
This crackdown has raised serious concerns about the misuse of codeine-based syrups as addictive substances. To understand this issue better, it is important to know what codeine is, why it is added to cough syrups, and how harmful it can be.
Why is codeine added to cough syrups?
Codeine is an opioid medicine used to treat pain and severe, persistent cough. It acts on the part of the brain that regulates pain and cough reflexes. In medical terms, it is a cough suppressant — meaning it reduces the urge to cough.
Doctors prescribe codeine in very limited and specific situations because it is habit-forming. Prolonged or unsupervised use can lead to dependence, requiring higher and higher doses over time, which is why it is regulated under narcotic drug laws. Using it without a prescription can be dangerous.
Side effects and risks
According to Dr. Subhash Giri from RML Hospital, codeine provides quick relief by suppressing cough signals in the brain. However, its risks are much greater than its short-term benefits. Being an opioid, it causes relaxation and mild drowsiness, which increases the tendency for repeated misuse.
Regular or excessive consumption can lead to:
• Addiction and dependence
• Reduced effectiveness of smaller doses over time
• Slow and shallow breathing
• Confusion and disorientation
• Extremely low blood pressure
• Loss of consciousness
• Life-threatening overdose in severe cases
The risks are higher for pregnant women, children, and individuals with respiratory or other medical conditions. Therefore, codeine should only be taken under medical supervision and for a short duration.
Expert opinions
Dr. Giri says codeine is effective when used carefully but should be reserved only for severe coughs or pain. Long-term use increases psychological and physical dependence.
Dr. L. H. Ghotekar of Lady Hardinge Hospital adds that the rising illegal trade of codeine syrup is largely due to its misuse as a recreational drug, especially among young people. He stresses the need for strict monitoring and firm action against fraudulent companies to curb this growing problem.
