Doctors warn of codeine dangers after occurrence of acute confusion in daughter, 14

Lack of efficacy and risk of poisoning and craving suggest use of over-the-counter codeine narcotics may be unwarranted, says report

Doctors have issued a warning about the use of over-the-counter medications containing codeine following what is believed to be the first published lawsuit of acute disarray in a 14 -year-old girl.

The dangers associated with codeine in cough remedies, both prescribes and otherwise, are highly unnecessary because of the lack of evidence that they actually work, the experts said.

Many mothers still dedicate codeine products to their children, despite regulators fears. This may be because of what they perceive as its strength, and its analgesic impacts, medical professionals from Ireland say in an article in the publication BMJ Case Reports.

The girl was assured at a hospital A& E department after five days of fluctuating confusion and amnesia, according to the report. She had been sleeping up to 20 hours a day, had a decreased attention span and suffered from intermittent headaches.

She had falsely reported having completed tasks, such as having showered, her mothers told physicians, and she also switched speeches while doing her homework. The girl had flu-like symptoms over 15 days, during which she missed school, and had been taking two to three spoonfuls a day of oral codeine phosphate over this time.

Although the girl had not exceeded the recommended daily dosage of three to six spoonfuls, she had outstripped the maximum recommended duration of three days. In all, she was thought to have devoured 450 -6 75 mg of codeine, instead of the maximum of 270 mg over any course of treatment.

The symptoms abated five days after the girl was admitted to hospital. There was also no codeine in her urine. A clinical review 2 week after she was discharged proved she was well and free of symptoms.

Confusion is a relatively unusual complaint in codeine intoxication, say the doctors, highlighting the necessity of thorough investigations. Codeine does however often affect the central nervous system and breathing and can cause severe rub of the scalp and flushes.

In April, the European Medicines Agency warned physicians against giving codeine to children and adolescents. It reviewed international data relating to coughs and other respiratory infections, including four demises, arising from codeine poisoning in children aged between 17 days and six years.

For coughings and colds in under-1 2s, it should only be used in special circumstances, relevant agencies said. Older children and adolescents with breathing problems should also not use codeine , nor should patients of any age who were known to convert codeine into morphine at a faster rate than normal.

The authors of the BMJ article say that although there was no evidence of codeine craving in this case, other studies had raised questions over codeine dependence in adolescents and vulnerable adults.

The combination of lack of efficacy, danger of acute intoxication and dependency, suggests the use of over-the-counter codeine preparations may be unwarranted, they said.

The UKs Medicines and Healthcare Products Regulatory Agency said: Codeine is a strong medication authorised for pain relief. It is not recommended for use in children or adolescents for the symptoms of coughing and cold as it is associated with a risk of respiratory side-effects.

If anyone has any questions, they should speak to their GP or pharmacist who can best advise on alternative treatments.

Professor Nigel Mathers, honorary secretary of the Royal College of General Practitioners, said: GPs are aware of the risks links with prescribing codeine and, in line with current guidelines, as a general rule we would not recommend medications containing codeine for children unless other alternatives have been explored and only when it is really necessary.

We would certainly not recommend these drugs for patients who have other conditions, such as asthma. But codeine is an effective cough suppressant and widely accessible without a prescription, so if patients do choose to take medications that contain codeine, we would urge them to read the label carefully and stick to the recommended dose.

Neal Patel, a pharmacist and the head of corporate communications at the Royal Pharmaceutical Society, said: The UK Commission on Human Medicines advises that over-the-counter liquid medications that contain codeine should not be used for coughing suppression in people under 18.

There is only limited evidence that codeine is effective for treating cough and cold symptoms in children. The hazards outweigh the benefits for treating the symptoms of cough in this age group.

Codeine-containing medications are unsuitable for treating pain or coughing in children under the age of 12 due to the potential seriousnes of side-effects.

Pharmacists advise that, when used, codeine-containing medications should only be taken for three days and only at the recommended dosage, as it can cause addiction. People with coughings that last for more than two weeks should seek advice about the cause from a pharmacist or GP.

Read more: www.theguardian.com

Why is the US banning kratom, the virtually harmless herb? | Marc Lewis

It acts on opioid receptors, hence the anxiety. But since some heroin users take it to ease withdrawal, its proscription could have some very harmful effects indeed

Just this morning I got an email from a head shop Id dropped into on my last trip to San Francisco. I didnt recall leaving my email address, but I certainly remembered the shop, festooned with fascinating herbs in colorful packets, unfamiliar plants, water pipe like octopi, merging aesthetics with efficiency. Sunshine streaming through the windows and the fragrance of incense, scarcely noticeable but enchanting as always.

I was visiting the haunts of my hippy days, the famous intersection of Haight and Ashbury, and of course everything seemed so much cleaner, more commercial, and, well, more legal, than it had back then. But what to buy? I dont commonly take narcotics anymore, legal or not, but I recognized the name kratom on several vividly coloured pockets on display behind the counter.

Kratom( Mitragyna speciosa) is sold as the crushed-up foliage of the kratom plant, grown in jungles throughout southeast Asia. You can stimulate kratom tea or dissolve it in juice to experience its effects, and its become increasingly popular all over the Western world( though its been around for centuries ). You can buy it at head shops, hundreds of internet sites, and now at kratom bars popping up in Los Angeles and other happening places. Obviously some people enjoy this legal high.

Kratom was indeed the subject of the email, and the tone of the message was urgent 😛 TAGEND

Important Info Regarding the Future of Kratom

In case you havent heard, theres a very important developing regarding your access to this safe and unbelievably helpful herb!

And then:

On August 30 the DEA announced their intention to place Kratom on the Schedule I list of substances starting September 30.

You can read all about this remarkable decision by the drug police. Theres a tidy article in Forbes, theres lots on YouTube, and the DEA sitesuccinctly states their rationale 😛 TAGEND

The Drug Enforcement Administration( DEA) today announced its intention to place the active materials in the kratom plant into Schedule I of the Controlled Substances Act in order to avoid an imminent hazard to public safety.

The first thing you should know is that Schedule I narcotics most famously heroin, and somewhat embarrassingly marijuana and LSD call for the most severe controls and penalties.( Meth and cocaine are nearby on Schedule II ). So the kratom user may end up cell-mates with meths and heroin addicts.

The second issue is why? Whats the imminent hazard to public safety?

I wasnt well informed any hazard when I asked the pierced young woman behind the counter what type of kratom I should try. I had taken kratom with a friend in the Netherlands where I live. Here its fully legal and sold in stores, as it is in most( but not all) Western countries. Kratom happen to be illegal in Thailand, apparently because it undercuts the lucrative opium industry.

I hadnt felt much the first time Id taken kratom and wanted to give it another try. So I asked the young woman what she recommended and she brought out a menu card. Midnight Blue is the most relaxing, Sunrise is sort of inducing but mellows you out at the same time. Starshine merely helps you feel … centered. Each concoction was touted to profer a slightly different buzz. So I bought a couple of packs for about $20 and got a little … high?

High is a strong word for what kratom actually offers. This plant is just one of a listing of age-old plants and herbal extracts that construct people feel a bit peppier, a bit happier, a bit more relaxed. A listing that includes St Johns Wort, ginseng, wild lettuce, coffee( yes, coffee ), kava, lavender, valerian, betel nut the list goes on and on. The word medicinal is sometimes used. But high? That would be stretching it.

You can read all about kratom on the web, but perhaps one reason the DEA considers it an imminent hazard is because part of its consequence comes from inducing opioid receptors. You know, those receptors that get you smashed when you shoot heroin. Anything that stimulates opioid receptors and stimulates you feel pleasant must be very dangerous, so we shouldnt take any chances. In fact, lets ban alcohol( martinis owe much of their buzz to opioid receptors ), lets ban jogging( that notorious athletes high a long, gale road to the trough ). And while were at it, lets ban breast milk, which helps newborns feel relaxed because it too induces opioid receptors.

But kratom is not an opiate. The molecule isnt even vaguely related to morphine or heroin. Its only an herb. Its impossible to overdose on kratom. Youre likely to get a headache if you take too much. The roughly 20 deaths attributed to kratom in recent history are thought to be caused by other drugs: the National Institute on Drug Abuse notes that commercial forms of kratom are sometimes laced with other compounds that have caused demises. And considering the 88, 000 deaths per year linked to alcohol and the 28, 000 overdose deaths from opiates( heroin and analgesics) in the US alone, it seems someone isnt doing their math.

Is kratom addictive? Maybe a little. But not as much as coffee and cigarettes or Q-tips, tattoos, and Pokemon Go. And if you take it daily, guess what? It loses its effect.

Ive induced the DEAs announcement sound silly, even stupid. There they go again, banning whatever bothers them until voters in Colorado or somewhere start to object. But theres a terribly tragic outcome to be expected if kratom is banned. Because kratom attaches to opioid receptors, its an ideal route for heroin junkies to get off heroin with minimal withdrawal symptoms a harmless, herbal methadone substitute. This folk-wisdom is splashed all over the net and freely shared among drug users. If kratom is banned in the US, many heroin addicts who want to quit will go back to heroin instead, and many, many more people will die.

Read more: www.theguardian.com