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SAMRC calls for more vigilance from pharmacies amid over-the-counter drug abuse

A private security company found a pile of empty cough syrup bottles at various drug and criminal dens in the Verulam area, north of Durban. Image: Supplied/RUSA.

A private security company found a pile of empty cough syrup bottles at various drug and criminal dens in the Verulam area, north of Durban. Image: Supplied/RUSA.

Published Jul 5, 2022


Durban - Pharmacies should be more vigilant when selling over-the-counter medication that is often abused by drug users, says the director of the Alcohol, Tobacco and Other Drug Research Unit at the South African Medical Research Council (SAMRC), Professor Charles Parry.

A private security company found large amounts of empty cough syrup bottles in the Verulam area, north of Durban. The area where the bottles were located, according to the Reaction Unit South Africa (Rusa), is frequented by criminals.

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Rusa said it contacted pharmacies in Verulam and was informed them that the bottles contained Dextromethorphan or DXM, a replacement for codeine in over-the-counter drugs.

Besides purchasing them over the counter, Parry said drug users could have stolen the cough syrup from suppliers or pharmacies.

He said the council had focused its research on the abuse of codeine-related products but research on Healthline had shown that DXM, a schedule 2 drug in South Africa, could have the same addictive properties as codeine when taken in high doses.

“As a schedule 2 medication, one would need to produce some kind of ID (like a pharmacy card or a medical aid card) to purchase DXM, and you would not be able to pick it off the shelf yourself without engaging with a pharmacist or pharmacist’s assistant and having your purchase logged on the system.

“I am not in favour of up-scheduling OTC medications but do believe, like in the UK, pharmacists should be more vigilant and should question people purchasing such products as to why they want them and whether there are no other alternatives. We should look at where these products are positioned in stores and should be put out of sight.

“We may want to look at product sizes and if in pill form, limit it to say three days’ worth or one bottle of syrup and then recommend if symptoms persist for people to visit a doctor.

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“We also need to protect the supply chain to prevent illegal distribution of such products. Ideally, we would have a system whereby all pharmacies are linked electronically to prevent pharmacy hopping,” Professor Parry said.

Dexing, or robotripping, which is the act of consuming DXM recreationally, has a range of side effects on its user, which healthline has categorised from plateau one to four.

Rusa officers found the heap of empty cough syrup bottles while pursuing wanted suspects in the Verulam area. The bottles were found under bridges on Todd Street, on an unused railway line near Groom Street and in drains along the R102 Southbound lanes.

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“All three areas are frequently used by drug addicts and suspects sought for robberies and stabbings in the central business districts,” Rusa said.

Speaking to IOL on Tuesday, pharmacy owners, who asked to remain anonymous, said they relied solely on discretion when selling products that contain DXM or codeine.

“Pharmacist advice therapy was given to a consumer before they could purchase a product containing either one of the active ingredients.”

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They said it was known among those in the pharmacy business, however, that cough syrup was abused by many, hence, they would not sell more than a specific amount to a customer in the same week.