Cough medicine is used to reduce coughing and break up mucus congestion in the chest. Both over-the-counter and prescription cough remedies have changed dramatically since they were first introduced. While these medicines have been widely used to treat coughs for decades, recent studies raise the question of how safe and effective these remedies actually are.
Some of the earliest cough medicines were based on natural herbal remedies. In the mid-19th century, quinine powder was placed in a patient's tongue and allowed to dissolve. Derived from tree bark, quinine was an early treatment for whooping cough. Other medicines from this time period used peppermint or pine tablets, which were also dissolved on the tongue. By the late 19th century, doctors were also using super heated air to suppress cough symptoms and break up mucus.
In 1827, scientists were able to isolate codeine and morphine for the first time. Since that time, these powerful opiates have been used in cough syrups and a number of other medicines. Very little was known about opiate addiction during that time, and drugs like "Mrs. Winslow's Soothing Syrup" were given liberally to children to treat cold and cough symptoms. This product contained a full gram of morphine per ounce, which was not uncommon at the time. It wasn't until the end of the 19th century that society began to recognize the dangers associated with opiates.
Medicinal heroin was developed in 1898 by the Bayer Pharmaceutical Company. Bayer began using heroin to manufacture cough syrup for children and adults. This product was sold over the counter until 1913, when it was discontinued. By 1906, most scientists agreed that heroin, codeine and morphine were potentially addictive. In 1906, Congress passed the Pure Food and Drug Act, which required manufacturers to list all ingredients contained in cough syrup and other medicines. The purpose of this act was to inform consumers, not to restrict the use of opiates.
By 1914, opiate addiction was so widespread that Congress passed the Harrison Narcotics Act to restrict sales of products containing opium. Cough syrups containing heroin were no longer sold, and the use of morphine and codeine was tightly regulated. By the middle of the century, OTC cough medicines were primarily made using Dextromethorphan to suppress coughs and Guaifienesin to act as an expectorant. Prescription cough syrups containing codeine and morphine were also widely used.
A 2007 study by the American College of Chest Physicians found that OTC cough medicines are largely ineffective in relieving symptoms or shortening the duration of coughs in adults. A 1997 study by the American Academy of Pediatrics found that OTC cough medicines did nothing to relieve cough and cold symptoms or help children sleep. In 2008, the Food and Drug Administration considered banning cough and cold medicines for children under the age of six. Though this motion was rejected, the debate over the safety of these medicines is ongoing.