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Nigeria’s Codeine Syrup ban may not be because of that BBC documentary

The question of how Codeine Cough Syrups should be administered

In a documentary done by the British Broadcasting Commission (BBC), four Pharmaceutical Firms have been named in a Codeine Cough Syrup abuse scandal, prompting the question of the measures put in place to regulate the distribution of Codeine and Codeine Cough Syrups in the Country and also the question of how the prescription of a drug that apparently contains opioid is determined.

The National Agency for Food and Drug Administration and Control (NAFDAC), said it has commenced investigation of the level of involvement of four pharmaceutical firms in the Codeine Cough Syrup saga adding that appropriate sanctions would be applied for regulatory violations. The Pharmaceutical firms located in Lagos, Ilorin and Kano were linked to illicit supply and distribution of codeine-containing cough syrup in the documentary of an undercover investigation unveiled recently by BBC Africa.

In an interview with Vanguard, Director General of NAFDAC, Prof Mojisola Adeyeye, said the Agency was determined to get to the bottom of the matter. He said:

“As we speak, our inspection and enforcement teams are in the premises of the four pharmaceutical companies that were shown in the video. Our officials are there putting things on hold, and everything is being documented. When completed, we will prepare our report and then we will take appropriate action.

“The teams have got cartons of one of the products from one company in Ilorin and it has been put on hold. When we go for inspection and enforcement, the Standard Operating Procedure is utilised, so, if products that are fake or substandard are discovered, such products will be seized and destroyed.”

Before this, however, the Committee on the Codeine Control Working and other related Matter Group (CCRWG) was set up on January 23, by the Minister of Health Isaac Adewole in Abuja.

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In February, Oluwatoyin Odeku, a Professor of Pharmacy at the University of Ibadan who chaired the CCRWG, provided an update about the work of her committee and said codeine addition amongst married women was on the rise.

Many young adults are known to be addicted to several illicit drugs across several major Nigerian cities, but, in recent years, opioid-based cough syrups, in particular, have become a serious menace.

In the BBC documentary entitled Sweet Sweet Codeine, reporters clandestinely film staff of three major Pharmaceutical companies offering to sell thousands of codeine-based Cough Syrup bottles in illicit deals. The complicity of these companies which produce cough syrups locally helps explain the widespread availability of the drugs despite a government ban on over-the-counter sales. The documentary is the first for BBC’s Africa Eye, a new TV investigations strand, the latest in BBC’s expansion across Africa.

Cough Syrups are being produced on an industrial scale and irrespective of the fact that drug makers are legally bound to only supply to Pharmacies which in turn sell to patients with prescriptions, corrupt staff are taking advantage of the high demand on the black market and running parallel drug syndicates.

In reaction to the BBC investigation in which an Emzor Executive was filmed cutting a deal to illegally supply cough syrup bottles, Emzor Pharmaceuticals, one of Nigeria’s largest, has suspended the distribution of Codeine Cough Syrup. Also, the Ministry of Health has also announced a ban on the importation and production of codeine-based cough syrups.

Based on this timing, the BBC reported, on May 1, that its documentary had prompted a ban on the distribution and use of codeine even though the broadcaster noted that a Ministry spokesperson had clarified that the action was the culmination of a long time effort aimed at curbing codeine addiction and its attendant social implications.

“The body of the statement released by the ministry yesterday indicated that a working committee had been constituted by the government and they submitted an interim report,” The Ministry said.

Prescription of Codeine Cough Syrup

The United States National Library of Medicine records that “when codeine was used in children, serious and life-threatening breathing problems such as slow or difficulty breathing and deaths were reported.” And as such, codeine should never be used to treat pain or a cough in children younger than 18 years of age.

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Health practitioners all agree that administration of codeine cough syrup should be strictly based on doctor’s/pharmacist’s prescription, considering the fact that codeine contains opioid which can be very addictive and dangerous to health.

Opioids are a group of drugs that range from codeine to illegal drugs like heroin. Prescription opioids are primarily used for pain relief. They work by attaching to opioid receptors in the brain cells to release signals that block the perception of pain and boost feelings of pleasure.

The strongest legal treatments are usually only available by prescription from a doctor and include: morphine, tramadol, fentanyl, methadone, diamorphine, and alfentanil.

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