Commissioners should consult pharmacists about prescription and over-the-counter (OTC) medicine addiction to develop a better understanding of services needed, Public Health England has advised.

CCGs and local authorities needed to get a "full picture" of who was misusing medicines, what they were using and where they were obtaining them in order to commission "appropriate local responses", PHE said in guidance released last week (June 28).

It directed local commissioners to provide support for people dependent on OTC or prescription (POM) medicines.

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	Experts who encounter addiction in their work, such as pharmacy groups, were "an invaluable source of additional information", it said. It also suggested gaining an insight into controlled drugs intelligence by talking to controlled drugs accountable officers.

The drugs that commissioners and local authorities in every area needed to look out for included benzodiazepines and z-drugs, opioids and other pain medicines, stimulants prescribed for ADHD or slimming, some OTC cough and cold medicines, antihistamines and stimulants, PHE said.

Commissioners should look at data on prescriptions dispensed in the community and GPs' prescribing patterns and learn about illicit use of POM and OTC medicines from National Treatment Agency for Substance Misuse (NTA) data, it added.

Commenting on the guidance, public health minister Anna Soubry said she knew it was "a complicated issue" and the government wanted "to get it right".

Between 2009 and 2010, 32,510 people in England who received treatment from drug services said they had a problem with POM or OTC drugs, according to the NTA.

A study of 25 people with OTC addiction, published in the BMJ online last month, found that patients kept schedules of pharmacies they visited to avoid detection and few of them reported that they had been confronted about their requests for the medicines. It has been a "wake-up call" for some of those who were challenged, the report said.

The author, pharmacist and Sheffield University public health lecturer Richard Cooper, told C+D that pharmacists should ask patients a range of questions about their medicines use.