Sunday World recently reported that former SA football star Kaizer Motaung Jr had been admitted to Sandton Medi-Clinic, Johannesburg, after overdosing on “cough mixture”. According to the report, his wife, Cathrin Motaung, said she’d found an empty bottle of cough mixture and a syringe in Motaung’s car.
This episode placed a spotlight on the rising addiction to cough mixtures and codeine-containing medicines in South Africa. In fact, codeine is South Africa’s most abused over-the-counter drug and many consumers aren’t aware that the seemingly harmless medication they’re taking for the flu or for pain relief can be addictive.
READ MORE: Alcohol: SA’s most-abused drug
Codeine is an opioid that’s used to relieve moderate to mild pain and also suppress coughing. It can be found in pharmaceutical products such as Myprodol, Benylin, Syndol, Tensodol, Adco-Dol and Sinutab among others. It’s also used in the manufacture of heroin.
Clinical psychologist Mich Robb explains how codeine addiction comes about.
“Two things happen with codeine addiction. Firstly, because the dopamine receptors are reduced and are less efficient, the person takes more and more of the substance, building up a tolerance to it. Secondly, the body produces more adrenaline and when someone stops taking [codeine], the body still produces an excess of adrenaline, which causes the effects of withdrawal.”
Codeine is a pain-relieving medication that’s also good for treating a cough, so it’s a common product that anyone can buy at any pharmacy, Robb says.
“For many people, codeine is a normal painkiller that works well as long as the prescribed dosage is taken,” he explains. “But some people who have chronic pain start taking codeine more regularly, and when they do, they expose themselves to the risk of addiction. A lot of people end up falling in love with the feeling it brings them and continue taking it even when they’re not in pain, and this leads to addiction.”
He says that when people are addicted they get to a point where they drink half to a whole bottle of cough mixture at a time to get a high. Robb adds that many young people do it because it’s cheaper than alcohol.
*Samantha Mukheli tells DESTINY MAN about her 21-year-old cousin and his friends who no longer buy alcohol from the bottle store, using cough syrup instead to “turn up”.
“They all just go to the pharmacy and get about 4–5 bottles of cough syrup and are quite clued up about which brands to get that have codeine,” she says. “Then they get Sprite and make their way back home and have their party. Basically, the pharmacy is their bottle store and they say it’s a more economical option because alcohol is often so expensive.”
Mukheli says they often excuse their behaviour by saying they don’t smoke marijuana and don’t drink alcohol, drinking instead what is called “sizzurp”, a choice she thinks is influenced by hip-hop culture.
“There’s a huge hip-hop influence; it’s cool for them! The reason they say they drink sizzurp is because it’s cheap and because it’s ‘cool’,” Mukheli says.
And she isn’t far off the mark. Hip-hop culture has played a huge role in the increasing use of cough syrup as a drug among youth around the world, including South Africa. Sizzurp is often referenced in American rap culture as a drink of choice.
In 2002, popular American hip-hop group Three 6 Mafia released a single called Sippin’ on Some Syrup, which further popularised the concoction and gave it the name “purple drank”.
Rapper Lil Wayne is also widely associated with the codeine-based drink, and in March 2013 was admitted to hospital after having a sizzurp binge which resulted in him having seizures.