Cough mixtures: not always for cough.BACKGROUND:  Opioid based cough mixtures are readily available to the public and are generally used safely. However, like alcohol, their use can sometimes be a significant part of a dependence problem. OBJECTIVE:  This case study provides practical information for general practitioners in the detection, assessment and management of patients with cough mixture opioid dependence. DISCUSSION:  Opioid dependence is generally considered synonymous with heroin dependence or dependence on prescribed opioid analgesics. However, cough mixtures are a readily available source of opioids. People who become dependent on these mixtures commonly do not present for medical assistance until the problem is severe.