Sticky Business: Patterns of Procurement and Misuse of Prescription Cough Syrup in Houston

Abstract

Reports of recreational codeine cough syrup use have increased in Houston and in the state of Texas. Occasional and polydrug users increasingly have consumed codeine cough syrup (with or without alcohol or other drugs) over the past three years, accounting for a $40 increase in the price of an eight-ounce bottle on the underground economy. News stories regarding syrup abuse and reports of deaths by codeine overdoses suggested the need to explore this emerging drug trend. The investigator conducted a literature search of scientific journals and news media, interviews with community authorities, and guided interviews with 25 adults who reported using codeine cough syrup in the 30 days preceding their interviews. Participants were recruited through snowball sampling; interview transcripts were coded and content analyzed. Polydrug users reported a penchant for codeine syrup because it carries fewer legal consequences, is perceived as “safer” than illegal drugs, and is either free or inexpensive for users with Medicaid or private insurance. Participants reported methods for procuring syrup from physicians and hospital emergency rooms which they consumed or traded for money, goods, or services. Consumption patterns for chronic and occasional users are described. Reported side effects include a drowsy relaxed high, fatigue, loss of coordination, constipation, and urinary retention.