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Codeine linctus sales behind increase in pharmacy enforcement notices

The GPhC held a series of webinars to raise awareness of inappropriate codeine linctus sales

There has been an increase in the number of enforcement notices served to pharmacies, with the majority concerning the “high purchase numbers of codeine linctus”, the GPhC said.

A total of 21 of the 27 enforcement notices issued from October-December 2020 related to “a lack of governance and risk management around the sale of over-the-counter medicines, including codeine linctus and promethazine preparations”, the General Pharmaceutical Council (GPhC) said in papers published ahead of its meeting this week (February 11).

This is compared to the 11 enforcement notices served in the previous quarter, 10 of which also concerned the “lack of governance and risk management around the sale and supply of codeine linctus preparations”.

The enforcement notices – which can include an “improvement notice” or a set of conditions that pharmacies have to meet before they are able to resume their normal dispensing activity – were served following the GPhC’s “intelligence-led inspections”.

Raising awareness

In its council meeting documents, the GPhC said it “raised awareness of the issues and insights we found with the sector through stakeholder webinars”.

It also held an event “in one area of the country where a number of cases had arisen, working collaboratively with the local pharmaceutical committee (LPC)”, the regulator added.

A GPhC spokesperson told C+D today (February 10) that is “continues to work with LPCs to raise awareness about this important issue to ensure that pharmacy services are provided safely and that proper safeguards are in place for the supply of higher risk medicines”.

Last year, the GPhC placed conditions on the registration of six pharmacies after it discovered they were buying “unusually high” volumes of codeine linctus.

Pharmacists can sell codeine linctus without prescription, as it is classified as a P medicine under the Medicines Act 1968 and the Human Medicines Regulations 2012.

However, the medicine is considered high risk because it is known to have been misused, abused or overused, the GPhC warned at the time.

10 Comments
Question: 
What do you make of the GPhC's action?

FuckLawMakers Freedom , Marketing

This is crazy, people will just start extracting codine via CWE! What they need to do is stop telling poor people they are dumb and rich people they are smart! Perhaps then there will be less drug addicts. 

Interleukin -2, Community pharmacist

...what about certain multiples that openly stock flog by the hundreds kaolin and Morphine micture, J Collis Brown mixt etc ? How has the GPHC responded ? The hipocrisy of the whole thing riles me. Every community pharmacist knows that for every five otc requests in any community pharmacy 4 is for Codeine related preparations. The supermarkets and other brick and mortar pharmacies sell these products by the thousands on a daily basis. What difference does targeting a few online fledgling pharmacies make in what is clearly a nationwide pandemic ? Even ITV has done a documentary on this !  

Joe Locum, Community pharmacist

Every superintendent that has had their pharmacy instructed to stop selling the said medication should be struck off. Spineless GPHC in action again.

The online pharmacies that have stopped trading will open up under a different Ltd company on the same premises, same owners/superintendent.

Madni Sheikh, Locum pharmacist

I fully agree with Mr Shorter that medicines for potential misuse be moved back to POMs; after all they did with diclofenac & domperidone when they woke up to it & they are already bringing in fexofenadine & brought out ipratropium spray to ease pressure on GPs

Edward H Rowan, Locum pharmacist

This sort of problem will never be resolved until we document sales. How can we be expected to work out who's buying things regularly if we don't record the sales?

TC PA, Community pharmacist

I haven't stocked this stuff for years. Same goes for phenergan liquid and I only keep the tablets for prescriptions, never sell them. The small loss of sales isn't worth the potential risk and possible investigations. It's a shame in way because if used responsibly, the products work well from my experience.

Snake Plissken, Student

Had a lot of customers asking for said product above because the GP had said buy it from the chemist. When checked with surgery was the case too. Stuck between a rock and hard place. Well moved on since but can only imagine what it must be like now.

 

 

Edward H Rowan, Locum pharmacist

You don't have any kind of responsibility to sell whatever GPs tell their patients to buy.

 

M. Rx(n), Student

I do hope this instance does serve to underscore the importance of the Pharmacist within the community as it relates to medicines law and ethics and pharmaceutical care. The Pharmacist's education is intended to serve such a purpose within the community.

Any inclination to make medicines readily available to patients in service of self-care or personalized medicine comes with this risk.

Getting Shorter, Community pharmacist

I only stock/supply pholcodeine which has much less abuse potential, but the same action on a dry cough.

On a related note, I'd be perfectly happy if codeine was put back to POM... very little benefit at P strengths, so much abuse potential whether on purpose or not.

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