Doctors and pharmacists at odds over plan to make codeine prescription-only

Ok, for those suggesting this is a huge overreaction or you'd have to take multiple pills to overdose and few would be so stupid... Suppose you have a very bad back - you might take two panadol every day. You might think this is ok. Alternatively, you might pop them like candy, taking one or two every few hours. Or you might take 3 instead of 2 because they, you're a huge guy and figure more pills probably equals more relief.

But this attitude is why accidental overdose of paracetamol is quite common - in fact it's the single most common cause of liver failure in Australia. When a study was done in USA 48% of patients who had overdosed on paracetamol did so unintentionally. They didn't swallow a whole packed, either. Of those accidental overdosers, 60% had taken only slightly over the recommended dose (so 3 pills at a time instead of 2 over say a week) and 40% had never taken over the recommended dose but had taken the medication for several for weeks. None of these people meant themselves intentional harm. These serious side effects are also common with ibuprofen, aspirin and codeine.

If doctors recommend making these drugs prescription only, we should listen to doctors, not pharmacists. Pharmacists are smart people, yes, but they're not fucking doctors - and often large pharmacy chains are all too keen to pretend their workers are doctors. This line has been crossed quite a bit more in countries like USA, where pharmacists will rattle off all sorts of medical advice (and often get sued for it) but we're seeing the effect of pharmacy corporate here too. The trouble is, big pharmacies have at least some conflict of interest between good science and bad science.

Here's an example that isn't even terribly 'out there' (so not peddling a homeopathic treatment or magnets for back pain or anything else 100% bogus - which most pharmacies are quite happy to sell you). Vitamin C. The idea this vitamin does something for colds was raised and disproven in the 1950s, yet it has persisted mostly on the back of vitamin and drug companies, who shove the cheap ingredient into things like cold medicines. Selling you something like lemsip in addition to cold medicine is a total placebo, but some (not all) pharmacists will do so because hey, that's an extra ten bucks. Selling vitamins like candy is actually a pretty bad idea, but it makes up such a huge portion of pharmacy sales, these stores place those sales high above their benefit or risk. And taking vitamins does have highly questionable benefits: at best when you take extra vitamins you have merely bought yourself soon-to-be expensive urine. Supplements do little of what they claim, and unless they are prescribed specifically to treat a deficiency, should be avoided - because they are actually also dangerous. Vitamins - especially antioxidants like vitamin C - when they were studied in a large scale study to see whether they might help other diseases, were found to actually cause a greater incidence of lung cancer. This effect is still being looked at, but calls into question the safety of over the counter vitamins. This is some years back, yet your average pharmacist would still gladly sell you product containing high-dose vitamin C knowing they will have absolutely no benefit whatsoever and might be misused.

Anyhow, there are probably better methods than taking these things off the shelf. Some options might be limiting the number a person can buy, or if they were made prescription-only, maybe requiring that prescription only once a year (similar to something like say the contraceptive pill) so a person has to go to a doctor at least occasionally to be monitored.

/r/australia Thread Link - theguardian.com