Warning Against Toxic Cough Syrup: Thailand

[webfact]

Warning against toxic cough syrup

The Nation

BANGKOK: -- The Food and Drug Administration has issued a warning about a toxic cough syrup that has caused at least 17 deaths in Pakistan.

FDA secretary-general Boonchai Somboonsuk said the Tyno brand cough syrup hasn't been registered in Thailand. The agency has ordered checkpoints to be on watch for Tyno. Officials say the fatalities are mainly among drug addicts who drank the syrup to get high.

The FDA and Public Health Ministry officials also checked drug stores and drug factories nationwide, Boonchai added.

"People who bring the cough syrup to Thailand will be punished, especially in the South," he said.

Tyno contains dextromethorphan, a cough sedative that is a controlled substance. According to FDA regulations, drug stores are limited to selling just three bottles at a time and 300 bottles per month.

-- The Nation 2012-11- 29

[Moruya]

"People who bring the cough syrup to Thailand will be punished, especially in the South," he said.

-- The Nation 2012-11- 29

Democrat supporters?

[jaltsc]

"According to FDA regulations, drug stores are limited to selling just three bottles at a time and 300 bottles per month."

300 bottles a month to the same customer? Must be one helluva cough.

[roxnadz]

Ha! I didn't know Thais got down with 'purple drank'!

Edited November 29, 2012 by roxnadz

[FOODLOVER]

Sounds like it works.

[Mosha]

"People who bring the cough syrup to Thailand will be punished, especially in the South," he said.

-- The Nation 2012-11- 29

Democrat supporters?

A rather odd statement in the OP

[Payboy]

It's back to the hospital then, for my codeine fix.

[HeijoshinCool]

"People who bring the cough syrup to Thailand will be punished, especially in the South," he said.

Does this mean if you are from the south then you get jail time but if from the north, a warning is appropriate?

No, "south" is a euphemism for, um, well, you know ....

[FOODLOVER]

Ha! I didn't know Thais got down with 'purple drank'!

For those not in the know. Foshizzle me thinks.

[unanimosity]

Sounds like it works.

[metisdead]

A post containing overly derogatory language has been removed.

[Scott]

I thought a lot of the cough syrups were mixed with Ipecac, which causes vomiting if you take too much. This prevents them from being misused by those who want to get high and also prevents overdosing.

[thatguy]

Tyno contains DextroMethorphan, which has been the go-to over the counter cough suppressant for generations. Anything with DM in the name. Drink half a bottle it will make you wacky, too much more likely kill you. What else is new?

[antpet]

Especially in the south .................................. Ok. Bring in cough syrup you get punished. At the airport I expect. But if you are coughing a real lot, and loud with it, then they send you to the south; as there they punish you more. Say twice the fine, twice the time.

What about if you have a cold along with a sore throat. Immigration send you to one side where a doctor is waiting to take a look. He thinks that sore throat could turn into a cough and you'd become cough syrup dependant. A syrup user. Maybe even a pusher of rosehip syrup on the streets of bangkok. Calling over to kids outside schools 'Hey Kid. yeah you with the runny nose. Want to try this? It's a kleenex'. It all starts with the simple misguided use of tissues and leads on to two paracetamol, vic vapour rub and even night nurse. Then there's cough syrup, lozenges, hot water bottles and the other cough paraphenalia.

In the Uk the punishments are harsh. When they punish you 'strongly' in the South it usually means a two week holiday in Eastbourne, forced bingo sessions, promenade walks, full english breakfast, boarding house accomadation and a virgin rail ticket home.

That is tough.

[stoli]

Even if it kills you, it is still effective in getting rid of your cough. Never seen a dead person cough....

[osiboy]

diphenely don't use this medicine !

[hellodolly]

I wonder if they have OK ed all kinds of ear medicine?

[Beng]

It's a mad, sad world. Our planet and it's population getting worse and worse. Shame.

[Rob8891]

I wonder if they have OK ed all kinds of ear medicine?

It was <cough> earmedicine that made me ill.... It all becomes clearer!!

[linno2]

I am in Pakistan for another week - this story all over the papers with various claims including that there is a manufacturer selling fake tynol with toxic ingredients, that the 17 dead were also drug addicts, that the bogus copy is made with opium, that all the therapeutic components are 'safe' but the 'fillers' ae toxic adn a few more newspaper alleged variables. Reality is that at this time they are not sure exactly what killed the 17 people until the toxicology results are known. In the meanwhile they have arrested the pharmacies that retailed the product. Lets hope if the product is proven to be toxic that no more people are affected. Seems also that not all people who drank the Tynol died from it - some just got sick. Watch this space!

[linno2]

Now 19 confirmed dead and claims by the families that the 'addict' allegation is to absolve the manufacturer from having to pay any compensation.

[astanhope]

Dextromethorphan (DXM) is a cough suppressant and is in most cough syrups. It is relatively safe, even in the high amounts required for intoxication. The intoxication it produces is "dissociative" and akin to ketamine or PCP. I would think that the danger associated with its use lies in injuring oneself in the immediately environment by falling or drowning, etc.

I don't think that getting high with dextromethorphan is a trend in Thailand.

In the South - [pause for racial slurs from the peanut gallery] - cough syrup containing codeine (and DXM) is used in a horrid brew made with kratom leaves and Coca-Cola. It would appear that the high sought from this brew is of the opioid variety, derived from both the kratom alkaloids and the codeine. The kratom alkaloids and codeine are also relatively safe, but addictive - but as opioids could potentially suppress breathing to the point of causing death. This is the mechanism behind most opioid overdose deaths.

It is not likely that cough syrup with the standard ingredients has caused the deaths in Pakistan. If the deceased were addicts, it is even less likely that they would have died from codeine overdoses, because as addicts their tolerance to opioids would be elevated.

One explanation might be that the manufacturer substituted for codeine or added another far more powerful (and possibly far less expensive) opioid like morphine, heroin or fentanyl (or opium, as suggested by linno) to either cut costs or to make their product more appealing to the addict community. Having read no more than the article above, sitting here in my armchair, that would be my guess as to the underlying story.

Edited December 2, 2012 by astanhope

[linno2]

5 more days before returning to BKK!! Update on the cough mixture........

"Adviser to Punjab Chief Minister on Health Khawaja Salman Rafique has stated that the investigation report into the incident took place at Shahdrah, where 19 people died after taking toxic cough syrup, would be released soon." from yeterday's Lahore Tribune where the deaths occurred.

Nothing in todays paper and this is already off the radar. Sadly 19 deaths is not a standout event worth reporting any more considering the daily newspaper reporting of large number of deaths due to gang rivalry in Karachi, drone strikes in Waziristan, suicide bombings, car bombs, Taliban attacks, outbreaks of disease (340 Dengue fever deaths in November last year in Lahore alone), neonatal mortality rates, bus accidents, natural disaters and so on. Thailand truly is paradise in comparison! Can't wait to get back on that plane!

Cheers

[linno2]

Front page of The Express Tribune Punjab Pakistan - "The allegedly toxic Tyno cough syrup manufactured by Reko Pharma recently blamed for the death of some 19 people has been cleared by the drug labs in Karachi and Punjab." but the story goes on to say that the results have not officially been released AND that none of the parents of the 19 dead would allow autopsies. So the commonly expressed feeling of Pakistanis is that this is 'being swept under the carpet' is a coverup due to some corruption payments etc etc. SO essentially if no autopsies then nothing to compare and contrast. Probably the end of story and families will not get compensation s they victims who all died in a couple of days 'were all addicts' - all sounds incredible!!!