Deafness Associated with Acetaminophen and Codeine Abuse

Department of Otolaryngology, University of Manitoba, Winnipeg, Manitoba.
Journal of otolaryngology - head & neck surgery = Le Journal d'oto-rhino-laryngologie et de chirurgie cervico-faciale (Impact Factor: 0.89). 09/2008; 37(4):507-9. DOI: 10.2310/7070.2008.0096
Source: PubMed


Ototoxicity associated with narcotic-acetaminophen combinations is not widely recognized. This can be the cause of severe-toprofound hearing loss that may be overlooked. Otolaryngologists who encounter patients with progressive hearing loss with no apparent cause should specifically ask about overuse of medications containing acetaminophen and a narcotic. Many patients feel that this form of medication is "safe" because it can be purchased over-the-counter. © 2008 The Canadian Society of Otolaryngology-Head & Neck Surgery.

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    • "Whereas CPHCS is a depressant, OTC cough syrup contains dextromethorphan, which becomes a powerful hallucinogen when misused (Furek, 2008; Lessenger & Feinberg, 2008; Schwartz, 2005). Abuse of CPHCS has been linked to deafness (Blakley & Schilling, 2008), delinquent behavior (Peters et al., 2007), the use of other drugs (Peters et al., 2003), and death (Gerostamoulos, Burke, & Drummer, 1996). Purple drank appears to have grown out of the Houston, Texas rap/hip-hop music scene. "
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    ABSTRACT: Recent social and legal responses to novel psychoactive drugs (NPDs) have been attributed to media panics rather than these substance’s actual harms. NPDs, including botanical substances new to Western markets such as Salvia divinorum, newly synthesized analogues such as synthetic cannabinoids and “bath salts,” and new ways of administering drugs, such as combining prescription cough syrup with soda (“purple drank”) have been the target of various forms of legislation at the state and/or federal level. We systematically examine print media coverage of NPDs in the U. S. between 2005 and 2013 to determine whether media attention was temporally associated with legislative change. Results indicate that each drug had a brief window during which it was the focus of sensationalistic reporting. In addition, federal legislation banning synthetic cannabinoids and “bath salts” appear to be closely linked to media reporting as spikes in coverage both preceded and followed the bans.
    Full-text · Article · Aug 2014 · American Journal of Criminal Justice
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    • "The harmful effects of codeine misuse and dependence are recognized by the medical community. [34,59–62] Misuse of codeine can occur in pill or syrup form, [60] with the misuse and tampering with codeine cough syrup well documented in the USA, [63] In- dia, [28] [64] Hong Kong, [65] [66] and Japan. [67] Over-the-counter and prescribed forms exist and contain various levels of codeine, dextromethorphan, and promethazine hydrochloride. "
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    ABSTRACT: Misuse of pharmaceuticals is of increasing drug policy and public health concern. A scoping review was conducted on the diversionary use of pharmaceuticals for non-medicinal use and home production of drug solutions. The research question was broad: What is known from the existing literature about the diversion of pharmaceuticals for non-medicinal use and for home production of drug solutions? The scoping process centred on the systematic selection, collection, and summarization of extant knowledge within this broad thematic remit. One hundred and thirty-four records were grouped into discrete thematic categories namely: non medicinal use and tampering with pharmaceuticals, oral misuse of codeine cough syrups, homemade drug solutions, and home-produced drug-related harms in the narrative review design. Forms of abuse of codeine cough syrup include mixtures with alcohol or soft drinks (‘Purple Drank’), with kratom leaves (‘Kratom cocktails’), or chemically altered to extract dextromorphan (‘Lemon Drop’). Production of homemade opiates (‘Cheornaya’, ‘Kolyosa’, Himiya’, ‘Braun’, ‘Krokodil’), methamphetamine (‘Vint’, ‘Pervitin’), methcathinone (‘Jeff’), and cathinone (‘Boltushka’) are described. Displacement patterns between the non-medical use of pharmaceuticals, commercial, and homemade drugs appear dependent on availability of opiates, prescribing practices, supervision of substitution drug dosing, availability of cheap ingredients, policing, and awareness of harms. Adverse health and social consequences relate to the use of unknown and contaminated (end) substances, injecting practices, redosing, medical complications, and death. The review highlights a public health imperative requiring a multidisciplinary approach to quantify potential impact and required integrated policy responses incorporating international regulation, enforcement, health surveillance and service delivery. Copyright © 2014 John Wiley & Sons, Ltd.
    Full-text · Article · Jul 2014 · Drug Testing and Analysis
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    • "Codeine cough syrup abuse has been documented in India (Mattoo, Basu, Sharma, Balaji, & Malhotra, 1997; Wairagkar et al., 1994), and Hong Kong (Lam, Lee, Shum, & Chen, 1996; Shek & Lam, 2008), and its deleterious effects including brain damage, deafness, and death have been examined in the United States (e.g. Blakley & Schilling, 2008; Davis, Baum, & Graham, 1991; Gerostamoulos et al., 1996; Hou et al., 2011; Romach, Sproule, Sellers, Somer, & Busto, 1999). However, research on the characteristics of codeine cough syrup misusers, and processes by which users come to experiment with purple drank has been limited. "
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    ABSTRACT: “Purple drank” is a label typically applied to mixtures of codeine cough syrup with soda, although it has also been applied to mixtures of over-the-counter cough syrups and alcohol. This novel drug formulation was first popularized in the Houston, Texas rap music scene in the 1990’s, and since then references to purple drank have become common in rap and hip-hop songs, but remained virtually absent in other musical genres. Prior research has found that musical preferences can have an influence on choice and frequency of drug use. The goal of the present study is to examine the relationship between musical preferences and experimentation with purple drank. Self-reported information about musical preferences, substance use, and demographic characteristics were collected from 2,349 students at a large university in the southeastern United States. An analysis of lifetime purple drank and other drug use by musical preferences reveals that those who prefer rap/hip-hop music and rock/alternative have the highest risk for reporting purple drank use. Further, this relationship far exceeds the associations between musical preferences and other drugs. Results from logistic regression analyses indicate males, other drug users, and those that prefer rap/hip-hop music have a significantly higher likelihood of using purple drank.
    Full-text · Article · Mar 2014 · American Journal of Criminal Justice
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