Instead of enjoying a soft drink, school children, including those at primary school, are sipping codeine cough syrup. The trend has prompted a Cape Town school principal to raise the alarm. This comes as the SA Medical Research Council is studying codeine misuse in South Africa.According to the council, codeine is a low-efficacy opioid, used to treat mild to moderate pain.Craig George, principal of Plumstead High School, said pupils used soft-drink bottles to disguise their concoction of codeine cough syrup laced with Disprin and crushed sweets to get an "instant high"."We started observing the appearance of cough mixture bottles, not only at my school but other schools as well," said George.He also noticed pupils carrying their own soft-drink bottles to school, rather than buying from the tuck shop.The pharmacy close to the school told him there had been a spike in pupils buying cough syrup that contains codeine."They are adding it into their cold-drink bottles, sometimes mixed with Disprin. The fix would be the same as drinking alcohol, an instant high," said George.He said it was not a new trend but was becoming more prevalent and primary schools could be facing a similar problem.George sent a warning to parents and will meet other principals tomorrow to discuss the problem.Codeine misuse in South Africa is still in its "infancy" said Tara Carney, of the alcohol, tobacco and other drug research unit of the SA Medical Research Council.In addition to looking at the misuse in South Africa, they are also scrutinising patterns in Ireland and the UK.About 25% of pharmacy staff approached in a recent survey had said South Africa is the only country where codeine-containing cough syrup is the most popular codeine product sold, said Carney.Popular cough syrups include Broncleer and Benylin."Codeine misuse is generally a hidden problem, and it is quite possible that the misuse of cough syrups with codeine is increasing as they are so readily available and it is easy to buy these products over the counter, often with no or few questions asked," said Carney.She added if adolescents started misusing codeine, they could move on to stronger, prescription medication containing codeine such as painkillers.She also highlighted research that found 11% of heroin users reported being dependent on or misusing codeine.Jessica Shelver, spokesman for Education MEC Debbie Schäfer, urged pharmacies to be aware who they are selling medication to...