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C+D readers want codeine linctus to switch from P to POM, poll shows

Over two thirds of pharmacy professionals who responded to C+D’s snapshot poll believe that codeine linctus should be reclassified as a prescription-only medicine (POM).

Of the 150 respondents to the poll – which ran on the C+D website from March 11–22 – 105 (70%) said they think codeine linctus should be reclassified from a pharmacy (P) medicine to a POM, while only 15% of respondents thought it should not be reclassified.

Twenty-three (15%) respondents said they no longer stocked the product.

Result

Do you think codeine linctus should be reclassified from a P medicine to POM?
Yes
70%
No
15%
N/A, we don't really stock this product anymore
15%
Total votes: 150
Codeine products “under review”

These findings come as the Medicines and Healthcare products Regulatory Agency (MHRA) told C+D last month that it is keeping the supply of codeine-based products “under review”, following a rise in concerns of over-supply or of it falling into the wrong hands.

Following the results of C+D’s snapshot poll, a spokesperson for the medicines regulator said: “The MHRA continuously monitors the safety of all medicines and seeks advice from the Commission on Human Medicines and its expert working groups on whether regulatory action is required when there is significant new evidence of a safety concern.

“The MHRA is keeping the legal status of codeine, including codeine linctus, under review and will consider all sources of evidence and information relating to this issue,” the spokesperson said.

Addiction concerns

Helen Devoy, a community pharmacist at Reach Pharmacy in Glasgow, said while reclassifying codeine linctus could help to tackle codeine addiction, she is concerned about a lack of support available to deal with the issue.

“Switching codeine from P to POM might make some people actually realise they are addicted and spur them on to tackle the issue. But, where will they go? Who will help them?” she asked.

Chris Campbell, a locum pharmacist based in Scotland, said: “We have such a bad codeine problem, cutting legitimate supplies would lead to a significant number of ‘addicts’ turning to black markets for their needs.

“This would lead to them being exposed to drug dealers who would lead them along different addiction pathways,” he suggested.

“Without significant investment by the government, the switch from P to POM would be an utter disaster.”

Solution to harassment issues

Meanwhile, a dispenser, who asked to remain anonymous, told C+D that they had a recent negative experience of declining to sell codeine linctus: “We had a patient trying to buy it a few weeks ago who got quite aggressive because we refused the sale.”

This was echoed by another pharmacist, who said: “I am fed up of the conversations with addicted people who try and repeatedly buy!”

Does your pharmacy provide addiction support services?

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