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Codeine addicts abuse pharmacists

Pharmacists are copping abuse and threats from customers refused addictive over-the-counter pills, in outbursts some have dubbed “codeine tantrums”.

Without any official way to keep track of codeine sales, pharmacists say they are unable to identify addicts who could be at risk of horrendous internal injury such as acute renal failure.

Popular codeine tablets taken in large amounts have caused at least nine deaths in Victoria since 2001, but industry experts say there is a common view all over-the-counter drugs are ‘‘harmless’’.

In Melbourne, pharmacist Adam Spiteri deals with up to four codeine tantrums an hour.

Recently, a man hurled a paracetamol packet at front-counter staff, spitting expletives, because he was told Nurofen Plus was not the appropriate medication for his headache.

In 2010 laws were changed, requiring pharmacists to be involved in all sales of codeine. Mr Spiteri said simply telling people that they had to see a pharmacist for the medication could set them off. “I’ve been called every name under the sun,” he said.


There are now widespread calls for a real-time drug monitoring system to be introduced in pharmacies, making it easier to identify “genuine” users.

Even the industry body that represents many drug companies is in favour of personalised electronic health records, but opinion is divided on whether to ban over-the-counter codeine sales altogether.

The Australian Self Medication Industry’s Deon Schoombie said people who went to the doctor for a codeine prescription could end up with stronger doses of the drug. The Pharmaceutical Society of Australia and Pharmacy Guild do not support making codeine tablets prescription-only, but believe the issue needs to be debated.

Victorian researchers say pharmacists are forced to stereotype customers based on their appearance and clothing, because they have no objective way to recognise codeine-hooked patients.

One pharmacist told a La Trobe University study “you’re judging them by their appearance which is not good to do but you have to”.

A 42-year-old man with a codeine dependence said he was more likely to be sold “48 tablets at a time” by a pharmacist if he was dressed in a suit and tie, according to a statement in another 2013 study.

“When I was in track pants and in my jumper they looked at me warily and a couple of them wanted to know my name and write it down,” he said.

The Pharmaceutical Society of Australia’s Irvine Newton said he often doubts he has made the correct decision when dispensing codeine, because of difficulties identifying problem users. “Each pharmacy has their own way of trying to respond, but we’re all struggling,” he said.

The federal health department says it has already funded a national controlled drugs electronic register, but it is up to each state and territory to implement it.

A spokesman for Victorian Health Minister David Davis said the government was currently “considering” a business plan “that analyses the options and potential costs” of implementing the system.

Recently some pharmacists have started to use a database set up to track pseudoephedrine ‘‘runners’’ to log codeine sales, an unofficial measure not supported by governing bodies.

This has allowed them, for the first time, to glimpse the lies they are being peddled.

This month a Melbourne pharmacist was told by a man who wanted Nurofen Plus that he only used it “occasionally” for back pain.

But the database showed he had been buying a packet every couple of days from numerous stores over the last six months, when the drug should only be used for “a few” consecutive days at most.

More than 1 million codeine packets are sold in Australian pharmacies each month.