Abuse and misuse of over-the-counter drugs ‘widespread’

ABUSE and misuse of over-the-counter medicines has become widespread and out of control, says the Pharmaceutical Society of Ireland.

Dr Mark Ledwidge, a member of the society’s Practice of Pharmacy Task Force, said there was anecdotal evidence of extensive misuse of products containing codeine, such as laxatives and cold and flu medicines.

Dr Ledwidge said the abuse and misuse was particularly difficult to detect.

“One of the key problems is that abuse such as this is hard to detect in victims as it is characterised by denial and secrecy and, as such, may not come to the attention of a physician or pharmacist until the problem is quite severe,” he said.

And available research and the nature of abuse also suggested pharmacists underestimated the true extent of the problem.

Most pharmacists who suspect a drug is being abused either refuse to sell the product or claim it is out of stock.

He said antihistamine-containing products may be used excessively for sleep disturbance or may be used for their sedative properties to mask other drug dependence problems. Abuse of analgesics, particularly codeine-containing medicines to relieve pain, could also result in death because they were combination products.

“Overuse of codeine means overuse of other medications, which may in turn, cause other unwanted effects, including death,” he warned.

He said laxatives were often intentionally misused to achieve weight loss and those who get into a vicious cycle of using laxatives can damage their bowels.

And Dr Ledwidge said people with an opioid dependence used codeine-containing cough medicines or antihistamines to alleviate withdrawal symptoms.

While pharmacists might be ideally placed to solve the problem, they might be limited in a number of ways of doing so effectively.

Dr Ledwidge said the best way to deal with the problem was to allow pharmacists to refer on individuals to addiction and counselling services. One such pilot project was underway in Cork city.

Dr Ledwidge has drawn up a discussion document on the issue. His document, written on behalf of the task force, can be viewed via the internet at www.pharmaceuticalsociety.ie and the task force can be contacted via email at [e-mail]