Press Release 7 September 2006 Abuse of Codeine-containing Cough Medicine

Overview of Drug Abuse in Youth in HK by Mr. Max SZETO and Ms. Jane TSEUI

Overview of Cough Mixtures Abuse in Hong Kong by Mr. David CHEUNG

The problem of drug abuse among young people was again brought to the attention of the public, after a thirteen-year-old girl was found dead on a street in Mongkok resulting from abuse of psychoactive drugs. The police have then taken a series of actions to raid suspicious community dispensaries. Thousands of bottles of codeine-containing cough mixtures for illegal sale purpose were found and many involved persons were arrested. But, are these just the tip of an iceberg?

According to the Survey on Drug Abuse in Youth of the Hong Kong Council of Social Service (HKCSS), the problem is getting worse. Abusing drugs before the age of fifteen is as high as 69.1% among all interviewees. Another report revealed that cough mixtures addiction is found in nine years old children. Cough mixtures abuse is becoming very common. It involves a wide spectrum of people, including the white-collars. The HKCSS report suggested that this had much to do with the enhanced accessibility of the youngsters to dangerous drugs, particularly the codeine-containing cough mixtures.

Cough mixtures with codeine concentration below 0.1% are available over-the-counter in community dispensaries. For those with codeine concentration of 0.2% or above, a doctor's prescription is required and available only in pharmacies in the presence of a registered pharmacist. In reality, codeine-containing cough mixtures are readily available in the market and anyone can drop by and pay for a "dose". Most sarcastically, many doctors complain about the shortage of codeine-containing cough mixtures and very often they are required to bundle with some unwanted medicines at the same time in order to get the supply.

Harmful Effects of Cough Mixture Abuse to Health by Dr. Ben CHEUNG

Abuse of Codeine containing cough mixtures in Hong Kong by Dr. CHOI Kin

The Hong Kong Medical Association has written to the Director of Health regarding the unbalanced distribution and inappropriate marketing strategy of pharmaceutical firms. The reply was disappointing. The Director stated in his letter that it would be the drug firms' "commercial decision" and "the Administration has already made it clear that it has no intention to regulate the business practice of drug firms and doctors in so far as sale of codeine is concerned". He also suggested to the profession to switch from codeine-containing mixtures to substitutes, which are known to be less effective.

The Association is concerned about the long-term negative impact to the health of the people. On one hand, we are losing control of the problem of drug; on the other hand, those in need are deprived of the chance to get more effective medical treatment. The Hong Kong Medical Association urges the various law enforcement units to toughen inspections and take legal actions against unlawful storage and sales of codeine-containing mixtures. The authority should fortify the implementation of current regulations on the sales of controlled drugs, for example, on recording personal information of drug purchasers, on restricting sales to the physical presence of a registered pharmacist and on stopping trafficking of controlled drugs into Hong Kong. In order to prevent drug firms from monopolizing the distribution of cough mixtures, the Department of Health should discipline firms, which adopt inappropriate sales methods, and review the current system of allocating import quota of raw materials for the manufacture of these cough medicines.

Despite all these effects, if the number of reported cases of drug abuse keeps on increasing, our Association would press for a total ban on the sales of codeine-containing mixtures in community pharmacies. Codeine-containing cough mixtures should only be available for bona-fide medical treatment from medical clinics or other medical institutions. There should be no more walk-in and paid drinks.

The Hong Kong Medical Association takes the opportunity to appeal for public cooperation. If you come across any case of illegal sales of dangerous drugs, please call our hotline at . Let's contribute to the health of our next generation.

Notes to editors:
The Hong Kong Medical Association, founded in 1920, aims to bring together Hong Kong's government, institutional, university and private medical practitioners for an effective exchange of views and co-ordination of efforts. The foremost objective of the Association is to safeguard and promote public health. The Association speaks collectively for its members and aims to keep its members abreast of medical ethics, issues and advances around the world. In fulfilling these goals, the association hopes to better serve the people of Hong Kong.

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