Cough syrup deaths: Victims’ families fight against overdose narrative
Twenty-six-year-old Muhammad Qasim worked nights as a rickshaw driver. His family knew he drank some syrup to keep his head “clear” and deal with his unnatural work schedule. They did not know exactly what he took but were not particularly bothered as it didn’t disrupt Qasim’s or their life.
Last Friday, on November 23, Qasim returned home to his house in Shahdara and went to sleep as usual. His sleep, however, was not regular and his mother, alarmed at the unusual snorting noises coming from the room, called in her younger son, Muhammad Adil, to check. Adil saw his brother foaming at the mouth. They rushed him to the Mayo Hospital where doctors treated Qasim in emergency.
“He came into his senses after midnight and told us he drank one bottle of Tyno, the cough syrup, as usual. He appeared fine at the time but died within a few hours,” Adil told The Express Tribune. What happened after made the tragedy worse for the family. “We were first told there was some toxic material in the syrup and everyone was very sympathetic. But that changed soon and we were told Qasim was an addict who died of overdosing and we would get no compensation,” said Adil.
Qasim was one of the 19 people who died between Friday and Sunday allegedly due to poisoning. Almost all the victims were residents of Shahdara Town, and, according to police and their families, regularly drank the sedating cough syrup, Tyno, manufactured by Reko Pharma, to “cool” or “clear” their heads or help them sleep.
The use of over-the-counter cough syrups as an intoxicant or as a recreational drug is quite popular worldwide. One of the active ingredients in Tyno is Dextromethorphan, which is a dissociative hallucinogen. When an entire bottle is consumed at a time, it can be a deliriant.
Overdose or poisoning
The Punjab Health Department immediately banned the syrup and arrested the manufacturer of Tyno, Khalid Salim Mian, who claimed in his bail appeal that the people died of an overdose. Mian was granted interim bail on Friday. He cited the initial inquiry conducted by the police and the provincial government that cleared the syrup and its ingredients as safe and not toxic. The initial investigations suggested the dead were drug addicts and had mixed some sort of an intoxicant in the syrup.
Qasim’s family vehemently refuses this allegation.
“If there wasn’t any poisonous substance in the syrup then why did these people die? All those who died had been using it for a while and if this was overdose as claimed by the government why did they not show any symptoms earlier?” asked Adil. He believes that Qasim bought a cheap and illegally manufactured version of the syrup distributed and stocked in Shahdara that contained toxins that killed his brother.
Investigations so far confirm Adil’s suspicions - the deaths in Shahdara were not due to overdose, as was earlier reported, but toxic poisoning. Officials privy to the investigations say that post-mortem reports have confirmed the patients died of asphyxia which is caused when there is a deficiency of oxygen in the blood. This deficiency is caused because of the presence of poison in the body.
It is suspected that the deceased drank a fake version of the syrup that was laced with toxic ingredients that may have caused the deaths.
The health department, police and senior doctors are jointly investigating the case. “We may send the samples to some labs in Europe or UK to find out what ingredient in the syrup was the troublemaker. The results would come soon and the people would know the truth,” said one of the investigators.
No decision on compensation
The Punjab chief minister’s special assistant on health, Khawaja Salman Rafique, says so far no decision has been taken to compensate the families of the victims. “We are investigating all aspects of the case. Tests are being done to find out what caused the deaths and who is to blame,” he added. The families are protesting this stand. They are claiming that the government is not taking their loss seriously as it is writing off the victims as addicts.
Muhammad Wali was the only brother of four sisters and sole bread earner. “He wasn’t an addict. He just used this syrup to get some peace of mind,” said Abdullah, Wali’s relative.
“It was the government’s job to check this medicine before it reached the market, and now by terming the victims drug addicts it cannot escape from its responsibility to compensate the families,” he said adding that there isn’t anybody to take care of Wali’s family now.
Qasim’s family shares this sentiment. “We haven’t even received sympathy in our grief what to say of compensation. The government acted as if those who died were not human beings,” a visibly disturbed Adil said adding, “My brother may have been an addict but he never used any drug or alcohol other than the syrup and was as healthy as any normal person. It is extremely painful to find out nobody actually cares about his death.”
Disturbing trend
This is not the first time this year there have been mass deaths because of fake medicines. In January, 165 people died after consuming contaminated heart medicine, according to official figures. Officials in the health department and senior doctors believe this case has raised questions yet again about the government’s ability to check medicines.
Pakistan Medical Association (PMA) Joint Secretary Dr Salman Kazmi said there were just 12 to 15 drug inspectors in Lahore to check thousands of medicines registered and sold in the city. “This number of drug inspectors cannot even check Lohari Market, a single wholesale market where locally manufactured medicines are sold. How can they check thousands of medical stores across the city?” he said.
In Pakistan, number of registered medicines is above 55,000 compared to just 5,000 in USA and 2,200 in UK. According to an official of the health department it is nearly impossible for the government to check this number of registered medicines. “The government should speed up its work on establishing the Drug Regulatory Authority and check the sale of unregistered medicines,” said a senior doctor requesting not to be named.
Published in The Express Tribune, December 2nd, 2012.
COMMENTS (3)
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If he drank one bottle that night he was definitely overdosing. It sounds like it's frequent use of that amount too. Also, medications have an over time detrimental effect when overdosing. Like people who overdose with Acetaminophen it will kill your liver eventually but by no means is it instant. It takes years. In regard to compensation, everyone will usually be denied if they died/were harmed while using more than the recommended dosage. The people wanting compensation from the company have rendered that impossible by admission. Not only that, but they were also admittedly using it for a reason other than the intended purposes of the drug. Unless the bottle says "Take 1 bottle to clear your head when you're stressed out" you are not going to get a single thing from them. Whether or not they were manufactured by people illegally is a valid concern but the blame ends up on those guys. It's illegal because they're not supposed to and part of that is because the company themselves are not involved in that production in any responsible way and use of their name is wrong because it bypasses guidelines associated with the company. You have people abusing a substance and the substance was a possible knock-off so the people who made it may be able to be tried in court for a number of offenses including murder, but you're not going to make money off of the death. Sorry your kids died but, they were drug addicts/abusers by definition. It doesn't make them bad people. But, they weren't taking and using it properly at all. Recommended use is stated primarily because that it will harm you if you take more than recommended. They did so willingly. Not by mistake. The fact they did it routinely testifies to addict behavior and consequences.
It's good that the media is highlighting both sides of the issue. Imagine if this happened a decade or two ago, there would've been no outcry, and probably no justice. Baby steps, even if we're in an almighty mess.
this is the right way to go about it, not get sucked in blindly into the hype and investigating fully, then justice should prevail!