Cough medicine use more restricted

Chinese authorities have tightened management of a cough suppressant called dextromethorphan and several other psychotropic drugs to prevent their illegal sale and use, according to a notice released by the National Medical Products Administration and National Health Commission on Tuesday.

The notice follows a circular released earlier this month stating that dextromethorphan, a medication tied to overdoses among teenagers and online clandestine dispensaries via social media platforms, would be placed into its national catalog of Category II Psychotropic Drugs. The categories of several other potentially addictive or controversial drugs were also adjusted to facilitate more severe regulations.

According to the notice, manufacturers of dextromethorphan should apply for designated production qualifications from local provincial-level regulators and report their production plans for this year.

Starting on July 1, manufacturers that fail to obtain the required qualifications are barred from making the drug or from outsourcing production.

Drugmakers are also required to change labels and instructions to align with the change in category.

Meanwhile, companies that are not certified to sell medicines belonging to Category II Psychotropic Drugs are not allowed to procure dextromethorphan, effective immediately. Their existing inventories should be reported to local drug regulators and handled in accordance with regulations. Medical institutions are also required to step up management of these medicines, it added.

Dextromethorphan is usually prescribed to relieve coughing caused by the common cold and other upper respiratory infections. It is structurally similar to the opioid substance codeine, but it was considered nonaddictive and was sold over-the-counter.

However, medical experts have raised concerns over its safety, saying that excessive use may result in feelings of excitement, euphoria and hallucinations.

In December 2021, the National Medical Products Administration changed its status to a prescription drug and deleted a description on the drug information label, which stated that long-term use of the drug does not lead to addiction or tolerance.

Dextromethorphan is also on the list of medications banned from being sold online. The list was first released in December 2022.

However, misuse of the medication remains rampant among teenagers as online chat groups have provided them with an illicit channel to obtain drugs. The phenomenon prompted authorities to launch a drive in February last year to control its manufacturing and intensify oversight over its use.

Xu Jie, a doctor at Beijing Gaoxin Detoxification Hospital, said during an interview with Chinanews.com that he received his first patient addicted to flu medicines like dextromethorphan in 2016, and the number of such patients has increased significantly over the past few years.

"The majority of them also suffer from mental conditions and are teenage students under age 18," he said. "Long-term use of these medications will cause harm to the body comparable to traditional narcotics."

Xu said that it is vital to impose tighter restrictions as well as address the psychological roots of addiction among young people.