Date of prep: December 2020
Prescribing information and
adverse events reporting
For healthcare professionals only
In response to the following article:
Dear PIP editor,
I’m not sure making all opiates prescription only is the way forward. Ultimately, patients having access to moderate strength painkillers from a pharmacy when needed is a good thing in my view.
But overuse or incorrect use and addiction is a problem that needs to be addressed. When I am running a pharmacy I have no idea if the patient who comes in asking for Nurofen Plus or any other opiate product has not just purchased a similar product at the pharmacy down the road.
Maybe there needs to be a way for pharmacies to write on the summary care record for all opiate sales so you can see a patients purchase history?
Or perhaps have it supplied on a patient group direction with fixed inclusion criteria. A message to the GP informing him or her of the supply would also be useful. This could help flag up any overuse at the GP practice end and make the GP prescribing system safer.
Turning to this particular story, I definitely do not think codeine linctus should be sold as a cough remedy.
Quite simply many patients do not measure their dose for cough syrup and swig it out the bottle which is so dangerous with an opiate.
Also, I have noticed over the years that a number of patients asking to purchase codeine ostensively for a cough. However, upon further questioning, it often transpires that they are really asking to use it as a sleep aid which is worrying.
I think over the counter abuse of opiates is significant. In my experience, so many sales are for combined opiate preparations like co-codamol. The patients requesting all know exactly what to say to get it and will often have the exact money in their hands.
I even overheard a conversation with two customers in which one said:
“Get the Nurofen Plus not co-codamol because you can take more without it hurting your liver”.
I don’t think making over the counter opiates prescription only would be a good idea. I think restricting quick and easy access to moderate analgesics is not a good thing.
But I do believe something has to change.
We either need to make supply more clinic-based with a full sit down consultation for moderate opiate analgesics or create a way of tracking patient purchases through the summary care record to monitor the use and flag up any problems.
Kevin Gilbert, community pharmacist.
The PIP team would love to know your views on over the counter opiates. Answer the questions below and with your permission, we will publish your response to this story as a letter to the editor.
Pharmacy in Practice is a UK pharmacy publication with its roots in Scotland.