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About LinkBacksAnd well they should... sure they are all gateway drugs aren't they?
And well they should... sure they are all gateway drugs aren't they?
The cake is a lie.
Could you list some of these better options?Originally Posted by Petrus
I think a reduction in casual purchase will result in a diminishment of casual misuse. This casual misuse is hard to give hard figures on as it depends on user surveys which are subjective and may involve under reporting.
You don't see how out of sight provisions will help.What harm could they cause, apart from decreasing sales ?
Speaking from personal experience I know I have only ever taken paracetemol/ibuprofen for pain relief. I have taken solpadeine for legitimate reasons but also on too many occasions because it acts as a general pick me up. Talking to others this seems to be a common experience. I had dental treatment recently and had reason to buy some, and when I did the pharmacist went into the spiel demanded by the new regs. I told him why I needed them, he was sympathehtic, but it made me think that if I had just gone into to buy them casually I might have hesitated and asked myself If i really needed them.
Which is the point I think of the regulations.
Yet you fail to clearly state any!?!
What is clear is that you are content to poke holes in what is a very minor (yet positive) change to the display of codeine products..... which may reduce the unintentional addiction of members of the public.
Addicts are addicts, and perhaps pharmacists who identify such may be able to signpost help for them, rather than popping it in a white paper bag with a packet of Mentholyptus. They would easily be identified by any gentle prying as to the ailement being treated.
In any event...history has demonstrated that in respect of the tobacco, asbestos, and other hazardous materials, the respective industry regularly employed both scientific and medical (professionals) and KOL's to periodically release statements throwing 'doubt' on any negatives.... I cannot remember the term for this unfortunately, perhaps some kind poster could look up their contract please.
The new Codeine guidance brings together a lot of information for pharmacists regarding codeine sales.
However the only change is the out of sight storage conditions.
If codeine abuse was a serious problem, in terms of numbers of mis-users, then I would have said a move to POM status would have been warranted.
If after research, it was shown to involve a small number of users then, mandatory sales protocols, a new recorded pharmacist sales protocol with a central database to record usage of all or of concerns. It would need a new schedule of OTC medicines requiring pharmacist consultation and recording.
I am not the source of all wisdom on this issue and know my limitations. Any changes would have to be debated fully in an open and inclusive way.
However, the principles remain, first understand the problem you are trying to fix. We don't have an accurate handle on codeine misuse, maybe the new guidance is OTT, maybe it does not go far enough. I don't know, and I still don't know what problem they were trying to fix with the only change they rought in the guidance.
Firstly, those regulations re pharmacists being satisified about OTC sales are already here, the only change in August will be the out-of-sight storage.
What harm could the changes do?
GSK announcing job losses. The price of codeine containing product rising, perhaps exhorbitantly.
Beaker, as I have stated previously. We don't know the extent of the problem, I have listed a few above, but we need to get hard facts about the problem first.
And yes, I suppose I am querying the need for the only change in the guidance. Does it go far enough, does it go too far?
Tell me first, what problem are the PSI trying to solve?
I have no problem with the change, but is it a rational and logical step to address a problem?
Beaker, I find your statement about popping "them" in a packet offensive.
Also I don't really understand what you are trying to say in your last paragraph. Are you trying to imply that by asking to understand the problem, debating that in an informed way with all stakeholders and then setting out regulations to adress that problem in a timely fashion, I am being unreasonably?
No, I think it is important to question, to debate, to define, to refine and to conclude. My only issue is to raise doubt without counter information whatsoever. In almost all other EU jurisdictions codeine is more restricted than in Ireland. While I don't advocate following the herd blindly, it would seem that there is a general trend at hand. It is not necessary to do exhaustive research on every issue to see if the result is the same in Ireland. It is unreasonable to think that the situation would be radically different, or that given time that the same situation would occur. Therefore it would be resonable to head off any snag like codeine becoming too 'loose' here.
As regards conducting research to discover whats warrented. We are just 4 million souls, and for many reasons, research conducted here is prohibitively expensive. As I have said, there is no reason to believe other than there are more similarities than there would be differences, the only difference may be temporal.
I would prefer the corporate loss of market share for sales of codeine by GSK or whosoever (and yes loss of jobs), rather than have a pervasive social problem with codeine and its congeners / derivatives as they have in the US. There is a whole industry there spawned by addiction clinics etc.
Petrus
I think you protest a little too much. If the new advice does not change much as I read it they certainly emphasise procedures that are currently not in common use - advice about use, duration, that it is a second level remedy, etc.
The provision relating to display seems to associated with the ban on promotion. Most chemist shops I've been in now have shelf space of several feet directly at the counter devoted to solpadeine- it is effectively banner advertising.
I'm surprised that it would be a professional concern of a pharmacist that an appropriate decline in use of a drug would affect a large pharma company. I'm also unsure how a decline in sales would result in an increase in price, but I for one would be happy to pay a premium on such products for the occasional times I would appropriately need them.
And "popping them in the packet" is an accurate description of most sales of solpo I've witnessed.
I agree, It is a pity this did not happen.
That very fact forms part of my doubt.
So we disagree with the necessity to do any research. However, we take a tiny little baby step towards the european norm and that's enough? I disagree, we should have done this properly!
If codeine use would not be radically different here, why are we so far from the european norm?
It would not have costed much to wholesales sales per capita accross a range of countries, IMS data!
I feel we should have conducted some research to inform the PSI's decision.
Codeine has been sold OTC in this country for decades. If the US has a problem now, why don't we? Or maybe we do and nobody knows! (because the research has not been done)
In reality all I am advocating is an informed decision making process.
I have no preconcieved ideas about the problem and a solution.
I was asking what problem the PSI was trying to solve with the out-of-sight storage idea. Am I to take it from the lack of an answer, that we are all in the dark?
You are entitled to your opinion and you are probably better placed than I am, as I have no need to visit a selection of pharmacies.
You asked the question "What harm would it do?"
I answered, however, it is not a professional concern of mine.
Regarding prices in a pharmaceutical market, there are precious few people in this country that understand the dynamics of this regulated market. There are none in the DoHC, HSE, IMB or PSI.
Again re the popping in the packet, Beaker was talking about sales to addicts!
Petrus
Would you agree that many pharmacies through their shelf placement of these products effectively advertise them?
And that most sales of these products are not currently accompanied by appropriate advice?
And that these products have become the first option for many for pain relief?
And that it is not uncommon that when someone asks for nurofen they are asked did they mean nurofen plus?
and finally, as a working pharmacist are you not even a little concerned at the increase in the volume of sales and patterns of usage?
Reminds me of when condoms were finally legal to buy here without prescription, never seen on display and something shameful to be buying.
What is this shame thing? some type of container? like a cup?
The enemy of my enemy is the enemy of my enemy. There are lies, damn lies and Fine Gael confusions. "I don't understand." Alan "it's only 79 punts" Shatter
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