Community Pharmacists’ Challenges with Non-Codeine OTC Cough Syrup Abuse Among Nigerian Youths
Abstract
Objectives: This study aimed to explore community pharmacists' experiences with non-codeine over- the-counter (OTC) cough syrup abuse among Nigerian youths aged 15-35, identify signs of misuse, assess barriers to intervention and reporting, and propose solutions to enhance pharmacovigilance (PV) practices.
Methodology: A cross-sectional online survey was conducted from October 3rd – 12th, 2025 using a structured questionnaire with 15 multiple-choice and open-ended questions, distributed via Google Forms to 60 invited pharmacists across Lagos, Ogun, Ondo, Rivers, and Abuja. Forty-five active community pharmacists responded (75% response rate). Data were analysed using descriptive statistics (counts and percentages) in Microsoft Excel.
Findings and Implications: Results indicated that 66.7% of pharmacists frequently or sometimes observed youths purchasing large quantities of syrups, with diphenhydramine implicated in 77.8% of suspected cases. Key signs included multiple bottle purchases (66.7%) and suspicious behaviour (66.7%). Barriers to prevention encompassed OTC regulations (44.4%) and lack of authority (22.2%), while none reported adverse drug reactions (ADRs) to NAFDAC due to unclear processes (33.3%). A significant association was found between pharmacists' experience (>5 years) and regular counselling. These findings highlight health implications such as increased risks of addiction, mental health disorders, and unreported ADRs, contributing to rising healthcare costs and youth morbidity. Socially, they exacerbate community stigma, economic burdens on families, and strain on public resources. By incorporating broader stakeholder perspectives (e.g., youths, regulators), the study underscores the need for policy reforms like prescription-only status for high-risk syrups and enhanced PV training, ultimately informing public health strategies to mitigate substance abuse in Nigeria.