The Curious Case Of The Everlasting Cough (2)….by Peju Adeniran.

Whenever I think of drug addiction in the young, Bariga comes to mind.

And even though I had lived in Lagos all my life, I did not think much of Bariga as a place, until one day, during a psychiatry rotation in school, a patient who was fighting drug addiction revealed that he was hooked on crack cocaine, a commodity that he easily bought off his friends who lived on the streets in Bariga. He said, he regularly bought wraps, for a mere 50 naira a hit.

The cheap price was going to be the first of my many surprises with drug addiction, as, for instance, I would later learn that in Northern Nigeria for example, a popular narcotic concoction of choice was made by boiling laundry blue, herbs and lizard droppings. (http://news.bbc.co.uk/2/hi/africa/2131440.stm ).

Another lesson, was realizing that many drug addicts did not necessarily use the narcotics or hard drugs that we have come to know and expect. In spite of available street drugs, most young addicts, (young in age and young in addiction) prefer to lean towards “softer” drugs at first, than to start at the top.

They like to use drugs, which they believe are cleaner, drugs they can “pull back from” believing that those ones are less addictive, and that they can stop them anytime they want.

That’s where Codeine falls into. If you recall, Codeine which has now become a ‘popular,’ ‘clean,’ and ‘soft’ drug came to my attention when a patient mentioned that her son had been on cough syrup for a very long time with no apparent relief from his symptoms, and also from the case of a woman who had seen children buy this cough syrup from a pharmacy with the help of an adult.

Weeks later, another case came up where a male senior secondary school student in a prestigious Nigerian school was found not only to have been abusing Codeine but had set up a lucrative business buying the bottles of cough syrup in bulk and selling in school to his classmates.

Matters came to a head when he was reported to the school by the parents of one of his customers who had had confessed his source. A search was carried out and hundreds of empty bottles of cough syrup were found under his bed.

His business had been going on for a long time, and everyone was amazed by how much money he had amassed by the time his business went bust. (The money was enough to amaze even his rich parents).

A codeine-high in a young person looks like this; a blunt, happy or dreamy expression all the time, with a reluctance to have an emotional response to anything; it is hard for people like this to get angry or anxious, some are immune to most physical pain.

It’s the classic prescription-drug addiction effect that has been described in movie and music stars; Michael Jackson being a famous example.

Now you can ask me; how could the parents have missed it in their children? Quite easy; they must have thought they had happy, easy going children.

Unfortunately, I was not privy to how the story ended. In spite of my efforts to follow up on how treatment for the addicted patient was sought and effected, not much was heard of how the case ended.

I still think of that case from time to time, and I am now deeply suspicious of people who come to me for cough medication especially those that recommend what medication I should prescribe for them especially when it involves codeine. In my head, I wonder if they planned on having an “everlasting cough” so I usually write a prescription for: “lots of rest, multivitamins and honey, then get back to me.”

We need to fight this everlasting cough epidemic!