Drug Awareness Week: Addressing Drug Overuse, Misuse, and Abuse
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The scourge of alcohol, drug and substance abuse knows no bounds and cuts across race, class and social barriers. Substance abuse destroys the fabric of our society and contributes significantly to a range of health-related conditions such as HIV/AIDS and tuberculosis, as well as chronic diseases such as cardiovascular diseases, cancers and mental disorders.
Almost 20% of South Africans – one out of every five adults – abuse mind-altering substances, with alcohol, painkillers, and dagga (marijuana) being the worst offenders. The rising figures of illicit drug use suggest the country is losing the war on drugs. The misuse and abuse of medications, especially those available over the counter, like codeine, is a growing public health challenge. While these medicines provide essential relief when used appropriately, their potential for addiction with overuse is a very real risk.
The South African National Council on Alcohol and Drug Dependence (SANCA) Drug Awareness Week, which takes place from the 24th to the 30th of June, is an opportunity to look back at the past, examine the present and look to the future in terms of how to effectively address and reduce the impact of substance use disorders. It is crucial to understand the dangers associated with drug misuse and encourage the responsible use of medications.
Understanding the Risks of Codeine and The Path to Addiction
Codeine is a widely used opiate found in various over-the-counter medications, including cough syrups, cold and flu remedies and painkillers. Although it is less regulated than other stronger opioids like morphine or oxycodone, it can still lead to significant dependency and addiction. According to Jackie Maimin, CEO of the Independent Community Pharmacy Association (ICPA), regular use of codeine can quickly lead to tolerance, dependence, and ultimately addiction.
“Many patients start using codeine-containing medication to manage legitimate medical conditions. However, overuse can lead to tolerance in as little as two weeks, requiring higher doses to achieve the same relief. This can lead to a cycle of dependency that is difficult to break,” says Maimin, who advises that symptoms of codeine dependence include mood swings, fatigue, depression, and even physical symptoms like constipation, withdrawal headaches and nausea.
Future Directions for The Control of Codeine – Expanding the Role of Pharmacists
The ICPA and many other stakeholders are advocating for enhanced measures to monitor and better control the supply of codeine. This would take the form of a centralised medicine database programmed to collect information on the sales of all codeine-containing medicines which would allow better monitoring and control.
“Pharmacists are on the front line and play a critical role in prevention and early intervention and so we’re focusing on empowering them,” says Maimin. “By training them to recognise and assist patients struggling with substance use disorder, we can catch problems early.”
“Education is crucial. Pharmacists can inform patients about the risks of codeine dependence and stress the importance of following recommended dosages. Knowledge empowers patients to use medications responsibly.”
Leveraging Technology for Codeine Monitoring
Pharmacists, as the custodians of medicine, are ideally placed to identify, monitor and control, the use of medicines with a potential to overuse, misuse or abuse. Currently, a key failing in the system is the lack of a centralised medication database which means that one pharmacy cannot view what has been dispensed in another unrelated pharmacy. Centralisation of data provides healthcare providers selling codeine-containing medicine with a full overview of sales of these medicines for a particular patient at the time of dispensing. This has many advantages for the patient as it will prevent duplication and possible overdosing of codeine.
“Technology is a game-changer,” Maimin continues. “This initiative would provide pharmacists with the necessary tools to monitor medication use more effectively, prevent duplication of medicines and identify patients who need help – which is crucial in addressing the opioid dependence crisis.”
The Dangers of Unregistered and Counterfeit Medicines and Why You Should Only Buy from Pharmacies
With the rise of online marketplaces and unauthorised sellers, the risk of obtaining unsafe medications has significantly increased, posing a serious threat to public health.
“These fake medications, including those claiming to be popular weight-loss drugs, pose severe health risks. Counterfeit and unregistered drugs often contain incorrect or harmful ingredients and lack proper dosages, leading to ineffective or inappropriate treatment and potentially severe health consequences,” warns Maimin.
“Purchasing medications from licensed pharmacies is crucial for ensuring the safety and efficacy of the medicines. Pharmacists can provide guidance on proper usage, check for potential drug interactions, and ensure that the medications dispensed are genuine and safe. Pharmacists also obtain medicines from reputable suppliers, ensuring that all medicines are stored and handled correctly, maintaining their efficacy and safety. In contrast, medications obtained from illicit sources carry a high risk of being counterfeit.”
Collaboration and Support
“Ultimately, this isn’t something we can tackle alone,” Maimin emphasizes. “We need a multidisciplinary approach involving healthcare professionals, regulatory bodies, and the community. By working together, we can create a supportive environment for those struggling with substance use disorders and ensure safe usage of medications.”
“By purchasing medications only from reputable pharmacies and staying informed about the risks of drug misuse, we can work together to combat this issue”, concludes Maimin. “Pharmacists play a key role in this effort, offering not only medication but also crucial support and guidance to ensure safe usage. As we observe Drug Awareness Week, let’s commit to making informed choices and supporting initiatives aimed at reducing drug abuse in our communities.”
Are You at Risk?
If you suspect that you or someone you know may be struggling with codeine addiction, seek help immediately.
For more information and assistance in fighting substance abuse speak to your pharmacist, GP or call the South African Depression and Anxiety Group (SADAG) 24-hour Substance Abuse Helpline on 0800 12 13 14. You can also call the South African National Council on Alcoholism and Drug Dependence (SANCA) on 011 892 3829 or send a WhatsApp message to 076 535 1701.
