Narcotics In Cough Syrup?

Almost all prescription cough syrup I get has some kind of narcotic or similar drug in it: codeine, hydrocodone, and I believe vicodin (sp?). Also, I know some cough medicines have alcohol (or at least they used to) as an ingredient. Why? Is it to relax muscles that might get sore from coughing? Is it to slow down respiration for some reason? Or is just some chemical thing, that the active ingredients combine better with these downers? Does anybody know? I ask, because I’ve been ill lately (but getting better, thank God), and have to make it a point to tell my doctor not to give me anything that would make me drowsy (I have a potentially dangerous job). So what’s the deal? Anybody know?

The codene (Amongst other narcotics) were the main ingredient in the syrup because it was known to soothe irritation in the bronchial tubes. Alchohol is merely a solvent (A bit better than water) to mix all the ingredients together.

Codiene, and other opiate molecules, tend to diminish the cough reflex by blocking a particular type of opiate receptor in the nervous system. If you’re coughing so hard you can’t eat or sleep or rest, the side effect of getting sleepy is no great hardship. If you’re not coughing that badly, you probably don’t need a cough suppressant. Remember, the cough is there for a reason, to protect and clear your lungs. Diminishing the cough reflex willy-nilly to suit one’s convenience is often not a good idea.

Non-sedating cough suppressants include any over the counter preparation with dextromethorphan, an isomer of an opiate-like molecule that crosses the blood-brain barrier rather poorly, but can get across enough to quiet the cough a bit. If taken in high enough doses, it has a PCP-like effect, with staggering gait, auditory and visual hallucinations, and a general dysphoria (as opposed to euphoria, like more typical opiates). Opiate addicts often turn to dextromethorphan when they run out of narcotics, hoping to mitigate the withdrawal blues a bit.

Nonsedating, but available only by prescription is benzonatate, which is metabolized in the body into a benzocaine-like molecule, and then secreted by lung epithelium, numbing and soothing the bronchial tree.

I did have one patient once who requested a narcotic cough syrup so he could smoke more during his illness. He was OK if he didn’t smoke, but when he lit up he coughed horribly. I told him it was a message from God that it was time to give up smoking.

Thanks for the info Qadgop, that was very helpful.

My mother has a mass of scar tissue in her lungs from the radiation (cancer) she is having more and more trouble with a persistent hacking debilitating cough. The cancer isnt getting any worse, but I figure its her lungs trying to expell what cant be expelled.

She is going to ask her oncologist (finally!) for a cough supressant so she can actually LIVE the rest of her time.

Your info about benzonatate will be very helpful.

Thanks again, very much.

Hope it helps, Kellibelli. Your mom might want to make sure she’s not taking any ACE inhibitors, too. They can cause a chronic cough, or aggravate a minor cough due to another cause. ACE inhibitors (like enalapril, lisinopril, all the other prils) are used to treat high blood pressure and protect the kidneys from the effects of diabetes. Angiotensin blockers (like Diovan) can be substituted for ACE inhibitors if there’s a problem.

Now, that was probably too much info, especially for my stab in the dark attempt to try to explain her symptoms without me knowing her at all, but you never know.

I don’t know what prescribing restrictions in the US are like, but there’s a strictly regulated cough medication here called Ticarda which contains morphine - usually given to people with conditions similar to your mum’s as the morphine component serves multiple functions including suppressing the cough. I could do a search and see if I can come up with a brnd name equivalent for the US if you like.