Undercover Coedeine

nder new guidelines from the Pharmaceutical Society of Ireland (PSI), the supply of codeine-containing drugs such as Solpadeine, Nurofen Plus, Feminax and Uniflu is restricted. Customers who wish to relieve their aches and pains with these products will have to go through a ‘consultation’ with the pharmacist before buying them. Sounds like a bit of a pain. But are pharmacists actually following the guidelines? And what is the point of it all?

Codeine comes from the opium poppy. Yes, that same lovely little flower that got Dorothy and the Cowardly Lion all snoozy – not surprising really, seeing as the opium poppy is also source of morphine and, thus, heroin. (In an unreleased sequel to L. Frank Baum’s novel called Withdrawal from Oz, Dorothy returns to her monochrome world complete with cold sweats and the shakes). With origins like that, it might seem odd that the drug hasn’t been more strictly controlled before now.
“In many countries, codeine products are prescription-only,” the PSI’s head of communications Kate O’Flaherty told Hot Press, “and so codeine has always been an issue of concern, as the side effects can include addiction, along with drowsiness, dizziness and headaches. The new regulation means the controlled drugs have to be treated like prescription drugs, and cannot be self-served.”
So they’ve moved codeine products behind the counter, basically. But Ibuprofen and Paracetamol are usually behind the counter too, and unless you make the mistake I did recently and go in alone on Valentine’s Day, wearing baggy sweatpants and looking tired – thus causing pharmacists to assume you’re a suicidal Bridget Jones type and interrogate you – there’s no problem buying them. Codeine apparently is different now – or so they say.
“Pharmacists will only sell a customer codeine products if they are personally satisfied that the person needs the product, that they’ve tried other medications and that they’re fully informed about the proper usage of the drug and the side-effects,” explains O’Flaherty. “For example, if someone drives for a living, codeine isn’t suitable as it causes drowsiness. It’s just about enforcing good standards of pharmacy… what were once just professional and ethical obligations have become legal obligations.”
But are these “legal obligations” actually being carried out by Irish pharmacists? I hit Dublin’s city centre to find out how much codeine I could stock up on, and how tough the interrogation(s) might be.
First up: a small chain pharmacy in Dublin City South, where I asked for Feminax, a product for menstrual pain. The woman behind the counter got me a box with no questions, only pausing after ringing it up to ask “You’ve taken this before?” When I lied, answering in the affirmative, she handed the 20-tablet pack over, supplying me not only with an empathetic glance that conveyed silent sisterhood womanly understanding, but also 160 mg of codeine. Not bad for a shopping trip lasting under a minute.
Next up was a larger chain close by, where I asked for Nurofen Plus, which was handed over without question. Another score, this time 307.2 mg of the opiate.
In another branch of the same chain, I asked the male pharmacist for some Feminax, hoping he’d ask what I was taking it for, so I could throw him a knowing look and say “Because being a woman hurts. And I’m not just talking about dealing with my ex-boyfriends.” Alas, he merely threw a “You know about the new codeine thing?” comment my way before ringing up my 160 mg fix.
My first thorough questioning came in a pharmacy beside a medical centre. The employee at the register brought out a lovely pharmacist, who took me aside and enquired why I needed the requested Solpadeine. When I replied that I suffered from bad headaches, he took pains to explain to me that the mix of codeine and caffeine in the tablets could increase my pain. He asked how long I had been getting such headaches, and suggested I go to a doctor.
After my fictional illness was thoroughly detailed and his instructions were met with appropriate head-nodding, he deemed me responsible enough to be sold a 24 pack of Solpadeine, adding a further 160 mg to my stash.
I again asked for Solpadeine in a leading chain, claiming it was for my Dad, who “suffers from back pain.” After being asked about his medical history and previous medication use, I was told to pass on to him the information that was readily supplied about Solpadeine’s side-effects, as well as being warned that it wasn’t to be used by other family members for “normal pains.” Yeah, yeah, lady. Just give me my 160 mg. Thank you, I’ll definitely come again.
My last pit-stop was another pharmacy in Dublin City South, where I asked for Uniflu. No interaction, no questions asked, 240 mg of codeine? No bother.
Within an hour I’d accumulated six boxes of codeine products, bringing my total codeine measure to 1187.2 mg, enough to get me nice and… well, dead, if I took them all at once. And though I’d been asked a few questions, I’d blatantly lied my way through them without any difficulty. The new regulations seem to provide little more than an inconvenience, as anyone, including potential codeine addicts, can still buy the drug without major difficulty.
We are not in the business of naming and shaming here. What we are interested in is this: is there any point introducing regulations and laws which represent nothing more than lip service and which are subsequently routinely ignored or flouted?
And so I phoned Kate O’Flaherty to ask: what’s the point?
“The new regulations aren’t to stop people buying codeine products” said O’Flaherty. “We’re not going to refuse people, it’s just that pharmacists will now assess each situation to see if the medication is the most suitable choice.” When I pointed out that many of the pharmacies I had visited hadn’t followed the PSI guidelines, that they hadn’t asked me questions or provided me with information, O’Flaherty claimed that “the guidance that is given in the regulations is well-known by pharmacists, who will evaluate on a case-by-case basis, not go through it all.”
In other words, pharmacists won’t follow the guidelines if you don’t look like a crack addict or if they just don’t want to, even though it’s a legal obligation.
“There is a complaint process if anyone feels that a pharmacist has acted unprofessionally,” I was told. “Complaints are submitted to a formal process, and if issues repeatedly arise, their fitness to practice will be evaluated.”
But hey, maybe it’ll be like the smoking ban and it’ll be enforced eventually, with codeine users chatting and flirting in a cornered off section of the pharmacy while non-users mind their bags and coats. But until then, I know where to go should I ever want to drug up.