In the second part of our series on “The Drug Problem”, we look at a seemingly harmless cough syrup that when abused adversely affects students’ health and academics.
By Yasiri J. Kasango
A growing wave of codeine abuse among university students is silently eroding academic futures and wreaking havoc on students’ health. Once a common prescription for cough relief, codeine is now a street drug of choice among many young Ugandans.
In a candid and chilling testimony, a former user, a university student who requested to remain anonymous, shares how he has experienced the highs and lows of codeine. His story mirrors those of many others who are now dependent on the drug.
“If you’ve never been through the system, you’ll never understand it,” he says. “I’ve done it. I’ve known what is good and what is not good. That’s why I abandoned the mission.”
It began innocently. The student recounts how he was introduced to codeine through international students, particularly Nigerians, during his university years.
“In Nigeria, it was already a big issue. They even banned it,” he says, referencing the 2018 Nigerian government crackdown after a BBC documentary exposed widespread abuse.
He was curious, surrounded by peers who were using the drug casually, often mixing it with soda. “It was normal to them,” he adds. They would entice one by the way they spoke about it.
Codeine, among its users, is typically consumed by mixing the syrup with soft drinks like Sprite or Fanta; it gives users a euphoric high. But the journey from experimentation to addiction is alarmingly swift.
“You start with one bottle, then two, then six. I did eight,” he confesses of how many he would eventually take in a day. “One cup of a bottle of codeine mixed in soda; the more you overdose, the better you feel.”
But the feeling comes at a price. Users build tolerance quickly, forcing them to increase their doses to chase the same high. Over time, the syrup no longer needs to be masked in soda; it is taken straight. “The more you take it straight, the more it hits differently. That’s the extreme,” he explains.
Addiction to codeine wreaks havoc on the body. Our source reveals how prolonged use left him with severe dental damage. “I’ve lost some teeth because of that,” he shares.
The drug also affects the digestive system, with constant urination and nausea reported among frequent users. “It disorganises your digestive system,” he adds.
Academically, the toll is evident. Students sink into sluggishness, losing focus and motivation. “You feel euphoric, lazy, dizzy,” he says. “Your brain becomes active in a strange way: hallucinations, flashbacks, confusion. Your past starts playing in your head.”
Uganda’s Constitution provides for the right to protection from harmful substances. Article 39 guarantees every citizen the right to a clean and healthy environment, a provision that implicitly obliges the state to protect its people from public health threats, including drug abuse. Furthermore, Article 45 reinforces that the rights and freedoms enshrined in the Constitution do not exclude others inherent to human dignity, such as the right to protection from harmful substances. Yet, despite these legal safeguards, the growing ease of access to controlled drugs like codeine exposes a troubling disconnect between constitutional ideals and the lived reality.
Dr Daniel Ruhweza, a constitutional law lecturer at Makerere University, asserts that “the growing misuse of substances like codeine reflects a failure in regulatory enforcement, which ultimately compromises citizens’ right to health and a clean environment as guaranteed under Article 39 of the Constitution.” He calls for urgent legislative and institutional reforms to bridge the gap between law and enforcement, warning that without action, Uganda risks a generational health crisis.
Despite its dangers, codeine is shockingly easy to obtain in Uganda. Pharmacies and drug shops across the country dispense bottles without prescriptions, according to the student.
“You go to a pharmacy and ask for six bottles, cash. They don’t ask why,” he says. “Even drug shops have it. It’s all for profit.”
There are multiple brands on the market, including Ricodine, Codeine, and imported high-end brands like Jondo, with prices ranging from Shs5,000 to Shs25,000. “The more expensive, the more effective,” he explains.
Promethazine pills, often used as a substitute, are also accessible without regulation. “They are meant for medical use, but people are taking them for highs. The government taxes them, so they know,” he says.
To verify allegations of the easy accessibility of codeine-based drugs, we visited several drug shops in Mukono. At each location, obtaining the drug proved remarkably effortless. Upon requesting codeine, the only question posed by the attendants was, “Do you have a cough?” a mere formality that did not require proof or a prescription. This revelation underscores the lax enforcement of pharmaceutical regulations and raises concerns about how such potent substances are being casually dispensed in communities.
The student has since abandoned drug use. This happened after he had a terrifying experience. He took a dose and found that he could not move for some time. The drug had hit him hard. “I couldn’t walk after one hit. Since that day, I have stopped. It was not mine,” he says firmly.
He is now speaking out, urging others to think critically, particularly those in leadership and public health. “There’s no way you can change the whole system,” he says. “But I’m doing my part.”
For him, the solution begins with awareness and accountability. “Talk to the DHO. Talk to someone. You may not fix it all, but someone has to start.”
Dr Elly Tumushabe, the Mukono District Health Officer, emphasised the importance of strict adherence to drug sale regulations in Uganda. “The law requires that all drugs be sold only through licensed pharmacies or drug shops and dispensed by qualified health professionals. Prescription-only medicines must not be sold without a valid prescription from a licensed medical practitioner,” he said.
He further noted the role of the National Drug Authority (NDA) in ensuring patient safety. “The NDA mandates that all drug sellers must offer proper counselling on dosage, possible side effects, and drug interactions. These measures are in place to protect patients, prevent self-medication, and address the growing issue of drug abuse and resistance,” Dr Tumushabe explained.
While the regulations are in place, they are not as enforced and so students continue to access the drugs which end up causing them severe effects both physically and mentally.
