Purple drank prevalence and characteristics of misusers of codeine cough syrup mixtures

Abstract

A mixture of codeine cough syrup with alcohol and/or a soft drink known as "purple drank" has gained media attention in recent years as a drug associated with professional athletes and southern rap music. The existing research on purple drank consumption has primarily utilized samples of African Americans residing in the Houston, Texas area. This is the first scholarly study of purple drank use outside of the Houston, Texas area among a general population of young adults, and indicates that purple drank use is not limited to African American males. The findings depict higher odds of the use of purple drank among other racial and ethnic groups, males, and homosexual, bisexual, and transgender college students from urban areas.

Cough, codeine and confusion

“…Another study in the USA reported the use of codeine cough syrup mixed with alcohol (so called ‘Purple drank’) among 6.5% of young adults. This study also showed higher abuse among the more vulnerable members of our society, including minority ethnic groups; lesbian, gay, bisexual and transgender individuals; and those from urban areas 8. These studies are supported by codeine being reported as second only to marijuana in prevalence of abuse among secondary school students in the USA 9…”

‘Codeine is my companion’: misuse and dependence on codeine containing medicines in Ireland

“…Access to existing treatment systems is hampered by stigma and poor consideration of needs, with pathways and outcomes complicated by requirements for the co-existing management of physical pain (Dobbin & Tobin, 2008;Fishbain et al 2008;Reed et al 2011). There is a public health and regulatory imperative to develop proactive responses tackling public availability of codeine containing medicines, risk minimisation in consumer self-treatment for physical and emotional pain, need for enhanced patient awareness of habit forming use and its consequences, and continued health professional screening and pharmacovigilence (Casati et al 2012;Cooper, 2013b;Agnich et al 2013;Van Hout et al 2014).…”

“…Within trajectories of codeine misuse and dependence, a wide ranging profile of codeine user exists; for example, the elderly (Roumie & Griffin, 2004;Agaba et al 2004); youth (Elwood, 2001;Peters et al 2003Peters et al , 2007aPeters et al , 2007bPeters et al , 2007cFord, 2009;Lao et al 2010;Wilson et al 2010;Tang et al 2012;Agnich et al 2013); parents (Allotey et al 2004); students (Acocella, 2005); pharmacy customers (Sweileh et al 2004;Albsoul-Younes et al 2010); drug and psychiatric treatment patients (Agyapong et al 2013); addiction treatment patients (Akram & Roberts, 2003;Myers et al 2003;Yang & Yuan, 2008;Cohen et al 2009;Thekiso & Farren, 2010;Cooper, 2013b) and internet drug forum users (Van Hout, 2015) each with their own motives, patterns and outcomes for use. However, there is a lack of consensus around a definition of misuse of pharmaceutical opioid narcotics (Barrett et al 2008;Casati et al 2012;Cooper, 2013a) with broad misuse of pharmaceutical definitions including incorrect but legitimate use for medical purposes; use outside of acceptable medical guidelines when self-medicating at higher doses and for longer than advised; use for reasons other than for the instructions on the label or the intended purpose; recreational use for intoxication purposes; and where risks and adverse consequences outweigh the benefits (Nielsen et al 2008;Casati et al 2012).…”

Misuse of non-prescription codeine containing products: Recommendations for detection and reduction of risk in community pharmacies

“…Misuse and dependence occurs in a wide range of groups, with studies reporting on parental medication of children (Allotey, Reidpath, & Elisha, 2004), recreational users (Agnich, Stogner, Miller, & Marcum, 2013;Ford & Good, 2007;Lam & Shek, 2006;Peters et al, 2003;, Peters, Williams, Ross, Atkinson, & Yacoubian, 2007, Peters, Amos, et al, 2007Van Hout, 2014a, 2014b, university students (Acocella, 2005), pharmacy customers (Albsoul-Younes, Wazaify, Yousef, & Tahaineh, 2010;Sweileh, Arafat, Al-Khyat, Al-Masri, & Jaradat, 2004), older people (Agaba, Agaba, & Wigwe, 2004;Roumie & Griffin, 2004), psychiatric patients (Agyapong et al, 2013), injecting drug users (Arora et al, 2013), non-treatment seeking individuals (Nielsen, Cameron, & Lee, 2011) and drug treatment patients (Akram and Roberts, 2003;Cohen, Unoh, Barry, & O'Connor, 2009;Cooper, 2013c;Myers, Siegfried, & Parry, 2003;Nielsen et al, 2008;Nielson et al, 2010;Thekiso & Farren, 2010;Yang & Yuan, 2008). Nielson et al (2010Nielson et al ( , 2011 highlight the unique and distinct nature of codeine dependence, as distinct from other forms of opioids, and identified a 'blurring' between use of codeine containing products for therapeutic, recreational and high dose purposes (Nielson et al, 2010(Nielson et al, , 2011.…”