Could Codeine Containing OTC Analgesics Sold in Romania be Used as Recreational Drugs?

Abstract

Abstract Objective: Analgesic medicines containing combinations of nonsteroidal anti-inflammatory drugs and codeine are available without prescription. Codeine, in these combinations can not be used recreationally due to the high toxicity profile of the nonsteroidal anti-inflammatory drugs. However, methods for extracting codeine from these types of medication are available on the internet. The purpose of this work is to evaluate if codeine can be extracted from codeine containing analgesics sold without prescription. Methods: High Performance Liquid Chromatography (HPLC) with UV detection was used to measure the amounts of codeine and nonsteroidal anti-inflammatory drugs recovered after applying an extraction method described on the internet. Results: The results show that codeine can be very easily separated from NSAID as aspirin, acetaminophen, ibuprofen using the cold water extraction method. However, very large differences (20 to 90%) were recorded for the recovery of codeine depending on the OTC product that was used. That large difference increases the risk of potentially lethal overdoses when the user switches between “similar” products. Conclusions: Our work shows that analgesic medication with codeine content can be recreationally used after the extraction of codeine. In order to prevent this, the sell of this type of products should be regulated or products that do not allow the extraction of codeine should be developed.