Attempts to buy codeine products at several Dublin pharmacies elicited a variety of responses, writes EOIN BURKE-KENNEDY
THE NEW regulations governing the sale of codeine products has put the onus on pharmacists to differentiate between potential problem users and legitimate cases. But this situation can be less than ideal, especially in busy high street stores, as this reporter found out.
Attempts to buy codeine products at several Dublin pharmacies last week elicited a variety of responses, ranging from perfunctory risk warnings to more rigorous assessments.
While all the pharmacies were upfront about the new rules and some of the risks associated with the misuse of codeine, only a few of the stores insisted I speak with the pharmacist about my symptoms prior to selling me products.
High street chain Boots, which has a reputation for strict adherence to dispensing rules, proved to be the most thorough.
At a busy city centre Boots store, an assistant advised me of the new measures before directing me to speak with the pharmacist in advance of any purchase.
The on-duty pharmacist then asked a number of questions about my symptoms – intermittent back pain in this case. After assessing my condition and what medicines I had taken for it in the past, the pharmacist dissuaded me from buying a well-known codeine product, steering me instead towards a milder alternative.
Despite a queue at the prescription counter and a number of conspicuously impatient customers, she insisted on taking individuals seeking codeine products to one side for a brief consultation.
A shop assistant in the same store later admitted that some people had complained about the intrusive nature of the new rules; others had simply switched to different products when faced with the prospect of having to justify their purchase to the pharmacist.
At four other chemists, however, I was sold codeine products without being forced to consult the pharmacist or being asked about my symptoms.
Although several friendly shop assistants at these stores apprised me of the risks associated with codeine and warned me not to stay on the medication for longer than three days, information about my condition or how frequently I used these products was not sought.
One city centre pharmacist said he had dealt with two cases of people getting withdrawal symptoms after taking one particular codeine product for several days. He said the individuals had mistaken their symptoms for those of the onset of a cold or an influenza bug.
All advertising of codeine products, including window displays and leaflets, has been banned under the new regulations.
At Unicare in Dún Laoghaire, shelves where products such as Solpadeine, Nurofen Plus and Uniflu Plus medicines were once displayed were now empty.
Instead, they contained signs saying: “These products are still on sale but are now hidden from view, with further information about the restrictions”.
At the store, the pharmacist said codeine was an effective analgesic for many people but acknowledged that it was important for users to be aware of the risk factors.
At another prominent Dún Laoghaire store, the pharmacist said he really only felt comfortable selling codeine preparations in cases of severe pain, such as migraine or chronic inflammation. He therefore broadly welcomed the restrictions.
However, he said, by failing to put the sale of codeine on a prescription- only basis as in other jurisdictions, the authorities had left the situation in a “sort of limbo”. The guidelines could be easily circumvented.
Because he worked as a locum in a number of pharmacies, he said, it was harder to filter out potential problem users from regular clients with legitimate complaints.
As a consequence, he was being forced to confront every customer with a number of potentially awkward personal questions.
The Pharmaceutical Society of Ireland has warned that stores which fail to adhere to the guidelines could face prosecution.
