Since a decree dated July 12, 2017, 70 drugs based on codeine or other opium derivatives (dextromethorphan, ethylmorphine, noscapine) are prohibited for free sale.

Henceforth, it will be necessary to get a prescription from his doctor to get them from his pharmacist.

But why such a decision?

What is codeine?

Codeine, along with heroin, morphine and methadone, are part of the opiate family. These substances are obtained from opium, a sedative product of natural origin that comes from the opium poppy.

Codeine (which should not exceed a threshold of 30mg per tablet) is found in two categories of drugs: analgesics, which aim to reduce moderate to severe pain (Codoliprane, Dafalgan Codeine, Klipal Codeine ...) and antitussives, whose purpose is to stop dry cough or irritation (Euphon, Neo-codion ...).

"Purple Drank", "Syzzurp", "Lean" ... When Codeine Invites in Explosive Cocktails

Problem: since 2013, codeine is not only used to relieve a persistent headache or stop coughing.

Teens and young adults divert it to purely "recreational" purposes by using it to create cocktails with strange names such as Purple Drank, Syzzurp, Lean.

The recipe is simple to make (and easy to find on forums or as video tutorials) since it is a mix of codeine, promethazine (a neuroleptic antihistamine that is used in this case to avoid nausea and vomiting) ) and soda. Sometimes alcohol, sweets or sweet syrups can also be part of it.

A drink that has become very popular in the space of a few years and tends to replace traditional whiskey-coca or vodka-redbull in the evenings.

The (presumed) fault of American rappers like Lil'Wayne, Asap Rocky or Future, who glorify codeine and these cocktails in their titles "Purple Drank", "Purple Swag" and "Codeine Crazy" (understand "crazy codeine" ).

The goal ? Feel sensations of "stoned", a term more commonly used by drug addicts. What horrify the parents of these young people totally unaware of the danger to which they expose themselves.

A physiological and psychological dependence comparable to that of drugs

According to the Global Information Network About Drugs website (GINAD.org), codeine, when taken in large doses, "produces a feeling of euphoria that, combined with its pain-killing properties, explains that one can easily have tendency to abuse it. "

Overconsumption that gradually leads to a "physiological and psychological dependence" as is the case for heroin. Sudden arrest may result in "withdrawal symptoms such as irrepressible urges, sweating, difficulty sleeping, nausea , diarrhea, muscle spasms and irritability."

In the most serious cases, the consumer can overdose and end up in respiratory distress: his lungs are racing and thus no longer play their role. The risk of death is extremely high.

An order to limit diversions

The decision to list codeine and other opium derivatives on the list of prescription-only medicines was made by the Minister of Solidarity and Health, Agnès Buzyn, the Directorate General of Health and the Agency National Health Products and Drugs ^1.

The minister hopes "to put an end to dangerous and potentially fatal addictive practices."

This change comes after the publication of a note from the French Observatory of Drugs and Drug Addiction (OFDT), in charge of observing the consumption of drugs coded by young people, who was already worried about their diversion in 2013 ² .

Subsequently, "suspicious requests for the release of codeine, abuse and even addiction cases among adolescents and young adults continued to be reported with a multiplication of cases from 2015."

A disturbing phenomenon, which had pushed the National Agency of Health Products and Medicines (ANSM) to warn health professionals about its misuse in March 2016 ³ .

Unfortunately, all these warnings were not enough to save Ronan, 17, and Pauline, 16, who died of cardiopulmonary arrest after an overdose of codeine in October 2016 and May 2017.

The petition of a mother who mourns the death of her daughter

Recently, Agnès Buzyn and Nathalie Richard, ANSM's deputy director, had just been arrested by Christelle Cebo, Pauline's mother, in a petition published on Change.org.

"Ten days of coma, ten days to see the body of our daughter caught in shaking, jerking, hiccups uncontrolled by all her fragile little body - myoclonus, medical term and certainty that her brain had been irreparably destroyed by the absence of oxygen supply following respiratory depression caused by codeine ...

Ten days of unbearable machine noises, beep of all kinds, to whistle your ears when you come home to take a shower and sleep a few hours ... ten days of hope, finally hear: "Madame , the medical decision was made, Pauline's brain is irretrievably destroyed, tell us WHEN to stop the respiratory assistance of your daughter ", can we read in his letter accompanying the petition.

A cry of despair that has no doubt accelerated the decision of the government and health authorities to no longer allow our children to get codeine tablets as if they were simple sweets.

Sources:
1. ansm.sante.fr/S-informer/Actualite/L-ANSM-publie-la-liste-des-medicaments-contenant-de-codeine-dextromethorphan-de-l-ethylmorphine-ou-de- the-noscapine-from now-available-only-on-prescription-Point-of-Information
2. www.ofdt.fr/BDD/publications/docs/eisxacx7v2.pdf
3. ansm.sante.fr/var/ansm_site/storage/original/application/80027bcf97abdb611490a158fab2b781.pdf