Because it is convenient to take and has obvious curative effect, it is welcomed by many patients. However, with the widespread use of cough syrup, an unexpected situation has emerged-cough syrup abuse addiction. Because most drug addicts are teenagers, especially middle school students, this problem has become a serious social problem.
In this paper, the current situation, mechanism, treatment and prevention prospect of cough syrup addiction were discussed, and a case of federal cough syrup addiction was successfully treated by using ultra-rapid detoxification (UROD) technology under general anesthesia, hoping to increase the understanding of cough syrup addiction among medical workers, patients and their families, so as to choose the correct treatment method without affecting the healthy growth of children.
1 Overview of Cough Drugs
According to the different links acting on cough reflex arc, the water content of cough medicine is central and peripheral. Central antitussive drugs can be divided into addictive drugs and non-addictive drugs. Codeine commonly used in clinic is an addictive central antitussive drug. Such as codeine phosphate syrup, because of its high codeine content (0.5%) and addiction, it is managed according to narcotic drugs. However, some commonly used cough drops containing codeine phosphate solution are not included in the management of narcotic drugs because of their low codeine content and non-addictive clinical therapeutic dose. However, if you take it for a long time, in large quantities and continuously, it is also prone to physical dependence and mental dependence.
Commonly used cough drops containing codeine phosphate include: Federated Cough Dew, Children's Federated Cough Dew, Federated Thai Le Qi, Novotel, Children's Federated Thai Le Qi, Fidyk, Coffey, Coffey Cough Dew, Compound Codeine Phosphate Cough Dew, Mrs. Pei Cough Dew, Wan Hui Huatan Cough Dew, Compound compound pholcodine oral solution Cough Dew (Otis Cough Dew for Children), Odin Cough Dew, Ou Doctor Cough Dew and Doctor Cough Dew. The content of codeine phosphate is generally around 0. 10%, such as 0. 10%, 0. 10% and 0.09% in Federal Cough Dew, Fidyk Cough Dew and Mrs. Pei Cough Dew respectively.
In addition, some Chinese herbal medicine syrups containing poppy shells, such as Li Qiang Loquat Syrup, Maqin Zhike Syrup, Qingre Zhike Syrup, etc. (the content of poppy shell is not indicated, but the clinical dosage is within the safe range), and it can also be addictive after long-term continuous use, because poppy shell contains morphine, codeine, thebaine, narcotine and other ingredients contained in opium.
2 Cough drug addiction status
In fact, cough syrup abuse addiction is not a new problem. It was popular in Hong Kong in 1970s and 1980s, especially among teenagers, and attracted the attention of relevant departments in Hong Kong. Through various intervention measures, the spread phenomenon has been contained and has been basically controlled at present.
In Chinese mainland, the abuse and addiction of cough syrup began to appear in Guangdong and other places in the late 1990s, and it has spread to a certain extent throughout the country in recent years. Now the relevant state departments have strengthened their management, but it is quite difficult to eliminate this phenomenon in a short time because there are many departments involved. So far, there is no epidemiological data, but according to news media reports, this problem has become a serious social problem in some areas.
In addition, in many entertainment places such as discos in China, the so-called "shake your head water" is abused, and mixing cough syrup with cola is essentially the abuse of cough syrup, which will also lead to addiction.
3 Cough drug addiction mechanism
The reason why cough syrup is addictive is that the codeine or poppy shell it contains is essentially an opioid analgesic. For example, codeine, also known as methyl morphine, has similar pharmacological effects to morphine, but its effects are weak. The euphoria effect of the same dose of codeine phosphate is only 1/8 to112 of morphine.
When patients take these cough drops continuously for a long time, the codeine phosphate or poppy shell contained in them acts on opioid receptors in the body for a long time, which produces euphoria when it acts on the brain and constipation when it acts on the intestine, similar to heroin addiction. In addition, with the extension of taking time, opioid receptors also change accordingly, which leads to patients' tolerance to such drugs, and it is necessary to gradually increase the dose to achieve the initial effect. If patients suddenly stop taking cough medicine, opioid withdrawal syndrome will appear. If the dose is large, the withdrawal symptoms will be very obvious, causing patients great pain. However, after taking cough medicine again, these symptoms will soon disappear, resulting in patients unable to get rid of cough medicine.
Of course, generally speaking, the withdrawal symptoms of cough medicine addiction are not as serious as heroin addiction, but because cough medicine addicts are mostly teenagers, their self-control is relatively weak, so they still can't stand the withdrawal reaction.
In addition, in addition to a large number of codeine phosphate and poppy shells acting on opioid receptors in the brain can produce obvious euphoria, some cough medicine water also contains ephedrine, which is a psychoactive drug (which can be used to make ice), thus aggravating the euphoria of cough medicine and making it more addictive.
It is worth pointing out that in general, the content of codeine phosphate or poppy shell in these cough medicines is not high, which has obvious inhibitory effect on cough center. Therefore, in the treatment of cough, the clinical routine dose has a clear antitussive effect, but it is not addictive.
4 Cough drug addiction treatment status quo
Because cough drug addiction is a relatively new disease in China, little is known about it in general hospitals at present, and there is almost no effective treatment. Some family members have no choice but to go to drug rehabilitation centers, but generally there is no good strategy in drug rehabilitation centers. Generally, patients are only required to stop using cough drops and use some auxiliary drugs to relieve withdrawal symptoms, but the effect is not good.
In particular, Zhike Lu is not addictive in clinical dosage, and its cough relieving effect is exact. Therefore, these drugs are not soft drugs. Moreover, most of the addicts are teenagers, who are addicted because of curiosity, improper medication or wanting to mingle with friends. They are victims and generally do not harm society, so they cannot be treated as "drug addicts".
More importantly, if you label your child as an "addict", it will become a psychological shadow of your child's life, which will seriously affect your child's healthy growth and cause great mental stress to your family.
However, if the parents insist on or are forced to stop using cough medicine at home, due to the objective withdrawal symptoms and lack of understanding of the disease, it will not only cause physical pain to the child, but also cause some mental and psychological problems, while the latter is much more difficult to treat.
Therefore, the best solution should be to have high-quality professionals to set up professional adolescent addiction correction and treatment centers, and find exact and effective treatment methods, from both physical and psychological aspects to treat both the symptoms and root causes, so that patients can get rid of cough drug addiction and grow up healthily.
These are for your reference.
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