One in three pharmacists suspects a patient of abusing over-the-counter (OTC) medicines every day, a C+D reader poll has suggested.

A poll of 283 readers found 33 per cent suspected addiction on a daily basis, while 30 per cent were suspicious about OTC medicine sales two or three times a week.

Only 10 per cent believed they came across OTC medicines addiction less than once a month, according to the poll, which ran from January 29 to February 4.

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	Experts told C+D that, while there were no concrete figures on the prevalence of the problem, anecdotal evidence pointed to it being widespread. They voiced concerns that pharmacists were struggling to intervene in the potentially lethal addiction.

Nick Barton, chief executive of charity Action on Addiction, stressed that OTC medicines could be "highly addictive". "There's enough anecdotal reporting to suggest it's a problem," he told C+D. "Certainly from the people we see in treatment, it fits in with their general abuse of substances." "The danger is that they might start using [OTC medicines] in combination with other things like alcohol," Mr Barton added. "There have been cases of people dying from overdoses of these combinations." Liverpool LPC secretary Jeremy Clitherow suspected the problem was "endemic" across the UK. Many people were unaware of exactly what was in OTC medicines, making the problem highly dangerous, said Mr Clitherow, who has a special interest in addiction. "You have people who go for the opium effect of codeine and are often unaware they are taking a massive overdose of paracetamol [with that medicine]," he explained. These worries were echoed by Tony Schofield, owner of Flagg Court Pharmacy, South Shields. Mr Schofield, an independent prescriber who specialises in addiction, said OTC medicines abuse was potentially a "big problem".

Medicines addiction: facts and figures 16 per cent of people in drug treatment services in England in 2009-10 had a problem with prescription or OTC medicines This rose to 27 per cent of people in drug treatment services in the north-east Prescribing of opioid analgesics increased more than five-fold between 1991 and 2009 OTC addiction support group Over-Count helped 16,000 people between 1993 and 2007 A survey run by Over-Count drugs information agency found Solpadeine and Nurofen Plus were the most commonly misused products, followed by generic co-codamol, Syndol and Feminax Sources: National Treatment Agency and All-Party Parliamentary Drugs Misuse Group

He said his work with the local drugs service had made him more confident than other pharmacists in making interventions, which had resulted in some customers getting help for their addiction.

"Usually they're quite emotional and we get them into treatment," Mr Schofield told C+D. "I can only think of one situation that was hostile and I contacted the patient's GP. He was admitted to hospital and, when he came out, he was really grateful."

But Sheffield University professor and pharmacist Richard Cooper, who has conducted research into OTC medicines addiction, said pharmacists often found it difficult to make interventions on suspicions alone. This could become even harder once the General Pharmaceutical Council (GPhC) allowed pharmacies to put P medicines on open display, he warned.

Prohibiting a sale when the patient already had the medicine in their hand could pose problems, Mr Cooper explained. "In the sense of the psychology of the transaction, it would potentially make it more difficult," he told C+D. "I think it could lead to more situations in which there is conflict."

The GPhC stressed that pharmacy owners and superintendents would have to take into account local medicines misuse when deciding whether to allow P medicines into open display areas.

"[They] would have to develop a risk assessment, which would include information about medicines that have been misused locally," a GPhC spokesperson told C+D. "Staff would also have to be trained to manage inappropriate sales and be alert to attempts to purchase medicines in order to misuse or abuse them."

Your shout

How often do you suspect a patient of OTC medicines abuse in your pharmacy?

Every day 33%

Two or three times a week 30%

Once a week 15%

Once or twice a month 12%

Less than once a month 10%

Poll of 283 readers on chemistanddruggist.co.uk, January 29 to February 4

Do you think it is up to pharmacists to tackle OTC medicine addiction? Comment below or email us at [email protected] You can also find C+D on Twitter, LinkedIn and Facebook