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Where there’s a will, there’s a way, and young South Africans are pretty adept at finding ways to escape the challenges of everyday life.

Our schoolchildren are far from the only youngsters who have taken a liking to mixing and matching drinks with codeine in them, but the extent of our usage is cause for concern.

The Bhekisisa Centre for Health Journalism is reporting on the rising trend of ‘dirty Sprite’, as it is sometimes caused, and points to a study of 31 countries to illustrate how widespread the abuse is.

Of those 31 countries, South Africa made up a third of all over-the-counter codeine sales between 2013 and 2019:

Codeine is found in mild painkillers and cough syrups, and is sometimes mixed with Sprite or alcohol to make a drink called “lean”…

Codeine is a mild painkiller of the same type as morphine, called opioid drugs. Opioids make your brain release feel-good chemicals and it doesn’t take too much to get to a drowsy, pleasurable high. Which is exactly what mixing 100ml of codeine-containing medicine with two litres of soda does…

Image: Dominic Milton Trott / Wikipedia

It’s a trap that’s difficult to escape, because opioid drugs such as codeine, morphine and heroin are addictive and over time your brain needs more and more of it to get the same high.

One regular user, who used a pseudonym for the story, is still using nine years after he first dabbled.

Exposure to the concoction often comes via social media. In the US, reports Medical News Today, “purple drank” or “sizzurp” first became popular in the rap and hip-hop scene in Houston, Texas.

Access to the ingredients is easy and cheap. For example, Stilpane (a pain medication) or Broncleer (a cough syrup) retail for between R20 and R30 for a 100ml bottle. Mix that with a bottle of Sprite and you’re good to go. Some pharmacies have even been guilty of selling codeine-containing products in bulk.

In response to the growing problem, and to try and avoid an opioid epidemic on the scale of what America is witnessing, the Pharmaceutical Society of South Africa and other partners launched the Codeine Care Initiative nine years ago.

However, it’s proven to be ineffective in certain areas:

…the Codeine Care Initiative was supposed to be a national database where pharmacists would be able to see every codeine purchase someone has made in the last six months, regardless of which pharmacy chain they visited.

But because the project wasn’t mandatory, only about 10% of drug stores in the country opted in, according to [Pharmaceutical Society of South Africa’s Mariet] Eksteen.

The South African Health Products Regulatory Authority (SAHPRA) could ensure that opting in was mandatory, which would make it easier to spot people who are buying unusual or excessive amounts.

Whatever step is taken next, this is a problem that has been around for many years and won’t go away unless meaningful changes are made.

[sources:bhekisisa&mednewstoday]