Ratlohogo Rafadi is a Research Associate under the SARChI Chair in African Diplomacy and Foreign Policy within the Faculty of Humanities at the University of Johannesburg.
He recently published an opinion article that first appeared in the Times Live on 04 March 2025.
Pharmaceutical companies and health regulators should immediately implement stricter controls on the sale of over-the-counter cough medicines and anxiety pills.
It is with a heavy heart and an urgent sense of duty that we raise the alarm on a crisis unfolding in our communities. Recent event held on the 8th of April 2025 at The Emperors Palace Convention Centre in Gauteng, including the Ministry of Police, all law enforcement and the National SAPS structures under the theme: Efficiency in Action “which. has highlighted the deepening collaboration between the SAPS and the business sectors which includes the pharmaceutical industry—in the fight against crime.
Our President Mr Cyril Ramaphosa has welcomed this whole-of-government and whole-of-society approach, particularly in light of escalating crimes against women and vulnerable children. In my view, I have done qualitative research and found that, a very disturbing undercurrent which remains largely unaddressed as our children are falling prey to a dangerous cocktail of substances, and it is time for the pharmaceutical industry immediately resolve certain risks by regulating some of their products
A crisis in plain sight
In our schools and neighbourhoods, young learners are increasingly mixing cold drinks—often popular brands like Buddy—with cough syrups and anxiety pills (including medications such as Myprodol) to create a highly addictive concoction. Shaken together in plastic bottles, this mixture is transforming the innocent act of recreation into a perilous gateway to addiction. Children arrive at school high, fail to absorb lessons, or, tragically, are found passed out in nearby parks during school hours.
The dangerous cocktail and its variations
A well-known variant of this abuse is the consumption of “lean” or “purple drank”; a term that encompasses various locally known names. Typically made from codeine/promethazine syrup, this mix is now supplemented with other substances.
A particular ingredient of concern is the white, round pill imprinted “MYLAN-A”, identified as Alprazolam 0.25 mg. Alprazolam, a benzodiazepine used for anxiety and panic disorders, is a critical component in this mixture, further impairing judgment and motor skills. Its abuse leads to the characteristic “lean,” where users have difficulty standing upright.
When cough syrup supplies are low on the market as it’s of high demand by the black-market syndicates, it is then often that the syndicate resort to substituting with mixtures of cold drinks and methylated spirits, also known as denatured alcohol. Locally referred to as “battery to coil” or “Petekwane” this alternative offers an intense high, compounding the dangers our children face.
Organised drug cartels: A menace in our communities
Our field research and community observation have revealed that those organised drug cartels are systematically operating in our townships and suburbs. These groups aggressively secure the supply chain by stockpiling cough medicines from pharmacies and small shops. They then regulate their own mafia-style prices, sometimes as low as thirty rand only (R30) for a 350ml ensuring a continuous and widespread distribution network that targets the most vulnerable members of our society: our children.
The tragic irony is that while our youth are drawn to these substances by the promise of escape and rebellion, their actions are heavily influenced by celebrities who inadvertently glamorize these practices on social media. The allure of popular international figures promotes a dangerous imitation, leading to addiction, broken lives, and lost futures.
The devastating effects of abuse
The abuse of these substances, particularly compounds like DXM (dextromethorphan), is not without severe consequences. DXM, whose effects have been compared to dissociative substances such as PCP and ketamine, can induce a range of harmful physical and psychological responses.
These include:
- Hot flashes, nausea, vomiting, and dizziness,
- Loss of coordination and impaired judgment,
- Panic attacks, seizures, and high blood pressure,
- Hallucinations, paranoia, and in severe cases, chemical psychosis.
Regular abuse of high doses may necessitate hospitalisation and can irreversibly alter brain function, threatening the future and well-being of our children.
A call to action
We are at a crossroads. The pharmaceutical companies and health regulators must immediately implement stricter controls on the sale of over-the-counter cough medicines and anxiety pills.
Bulk purchases should be monitored, with robust record-keeping and warning systems to flag potential abuse. Every loose regulation or unchecked sale is a step toward another child falling into addiction, which leads to violent crime.
At the same time, community leaders, educators, parents, and law enforcement must unite to dismantle the local drug cartels fuelling this crisis. Initiatives should include:
- Awareness Campaigns: Educational programs that extend from classrooms to spaza shops and social media, informing children and parents alike about the real dangers of OTC drug abuse.
- Parental Vigilance: Practical advice, such as monitoring the quantity of medication in the home and controlling access to these substances, ensuring that children are not tempted by what is readily available.
- Robust Law Enforcement: A targeted approach to investigate and dismantle the syndicates that profit from these dangerous mixtures before more lives are lost.
Our children are our future
We must never forget that our children are not just statistics or numbers to be managed, they are our sons, our daughters, and the bearers of our collective future. Ignoring this crisis is tantamount to abandoning our responsibility to protect them. We cannot and will not stand idly by as the pharmaceutical industry and associated regulatory bodies fail in their duty to secure our communities.
Today, we call on every responsible adult, every policymaker, every community leader, and most urgently, the pharmaceutical industry, to take immediate and decisive action. Our children are dying slowly, forced down paths of addiction and criminality, and the time for complacency has long passed.
I pause to mention that even some of our young adults are suffering from the same addiction as they are high number of unemployment and they feel so depressed. This also speaks to the issue that these illegal cocktails are also cheaper in price and easily accessible. No more. Not here. Not our children. We demand change, accountability, and above all, a commitment to a future where every child can thrive free from the peril of an uncontrolled drug substance addiction.
*The views expressed in this article are that of the author/s and do not necessarily reflect that of the University of Johannesburg.
