Powerful cough syrups could be prescription-only in the UK over fears of people becoming addicted.
Five over-the-counter codeine products will be restricted if the move goes through.
Drug watchdogs are concerned about increasing cases of serious and sometimes deadly side effects.
Health chiefs are also shocked by reports that the drug is being used recreationally for its potent opioid effects, rather than medicinally.
Now the Medicines and Healthcare products Regulatory Agency (MHRA) has launched a public consultation on prescription-only syrups.
These are the five codeine cough syrups the UK regulator wants to prescribe after disturbing reports of people becoming addicted to the opioid
If allowed, it would mean Britons who want codeine linctus – a specific kind of codeine drug – would be grilled by a GP before being allowed to buy it.
The MHRA said the move would only affect five products: Codeine Linctus BP, Bells healthcare codeine linctus, Care codeine, Galcodine Linctus, Pulmo Bailly.
These retail for just £3.20.
Other over-the-counter codeine products, such as tablets containing the pain reliever, would not be affected.
MHRA officials said they have received 116 reports of recreational drug abuse and addiction to codeine drugs, including cough syrups, since 2018.
Data from the MHRA also shows that reports of serious and fatal side effects have skyrocketed in recent years, with a record 35 fatalities in 2022, the most recent full year available.
Codeine is an opioid – a class of painkillers in the same family as morphine, heroin and fentanyl.
As with other opioids, people can become addicted.
Dr. Alison Cave, the MHRA’s chief security officer, said: ‘Codeine linctus is an effective drug.
“But because it’s an opioid, misuse and abuse can have major health consequences.”
In total, the MHRA received 243 reports of serious and fatal adverse reactions to codeine drugs in 2022 and 277 in 2021.
In 2023, there have been 95 such reports so far.
These reports, made to the Yellow Card reporting scheme, are not direct confirmation that a drug was responsible for or contributed to a medical problem, and may simply be a coincidence.
Professor Claire Anderson, president of the Royal Pharmaceutical Society welcomed the move.
“Drugs should maximize patient health benefits with minimal risk,” she said.
‘We believe that there is not enough robust evidence for the benefits of codeine linctus in the safe and adequate management of cough.
“We are also deeply concerned about its misuse and addictive potential, as well as the risk of overdose.”
She added that since there are many other, non-codeine products that can relieve a dry cough, the benefits of keeping codeine linctus as an over-the-counter option were limited.
This chart shows the codeine-related serious and fatal events reported to the Medicines and Healthcare products Regulatory Agency (MHRA) each year. Dark green areas of the bars show only fatal events, while light green areas are serious but non-fatal events
Pharmacist says with many non-codeine-based cough syrups available, ready availability of products containing the potentially addictive opioid was ‘questionable’
“With studies showing that up to 60 percent of people are genetically predisposed to opioid dependence, the role of codeine linctus in the treatment of what is ultimately a self-limiting condition is questionable,” she said.
Opioid addiction has become an increasing concern in both the UK and the US, with people secretly becoming addicted after taking the painkillers as part of medical treatment.
In the US in particular, devastating ‘Zombieland’ scenes of opioid addiction can be seen in some cities.
The audience of the MHRA consultation runs until August 15.