pharmacies and drug laws?

ygolometsipe

A few months into covid, I stared thinking well if I get it, I am quarantined for two weeks, so I should get flu/cold remedies now.

However when I went to tesco I never saw "drowsy" cough syrup. Eventually I realized this can only be bought in a pharmacy.

This "awakened" my views on drugs and pharmacies. The last pharmacy I visited even has aspirin in the "locked window".

Does anyone else think this is really strange. I mean in tesco you can buy
a case of whiskey (which is far more damaging) and no one bats an eye lid.

However you cannot buy two packs of paracetamol (despite the obvious fact that Tesco is everywhere an you could clearly go across the road)

What is the nature of this policy? it seems really strange.

I know in the USA/Canada (Ireland prescription level) drugs are freely available in pharmacists however the opioid epidemic was a doctor prescription issue.

what percentage of people in Ireland are abusing drugs at such a level that asprin need to be locked away?

I recently read a report that cannabis/cocaine and alcohol are the most widely used drugs in Ireland and can be bough online and delivered via the web/dark web.

is it odd or am i wrong?

degsie

Obvious solution is cannabis/cocaine on the shelves in Tesco. Sorted!

Atlantic Dawn

It's because people would "do away" with themselves if they could buy 2 packs in the same shop. If they had to go to 2 shops and buy a pack in each they would be perfectly safe...at least that's their idiotic plan.

Water John

One over dose of paracetemol can damage you liver TMK. Takes a long time drinking alcohol to achieve that.

Pkiernan

Try buying Sudafed in the US

2 packs of paracetamol will end up with you needing an infusion of acetylcysteine to stop acute liver failure. It is definitely far more dangerous than a bottle of whisky.

Also, a lot of paracetamol overdoses are spontaneous acts which when the person realises they can't get 2 packs, they can't be arsed going to another pharmacy to get more paracetamol.

Solpadeine abuse is the biggest addiction problem in ireland outside of alcohol and cigarettes.

ygolometsipe

Deleted User wrote: »

2 packs of paracetamol will end up with you needing an infusion of acetylcysteine to stop acute liver failure. It is definitely far more dangerous than a bottle of whisky.

Also, a lot of paracetamol overdoses are spontaneous acts which when the person realises they can't get 2 packs, they can't be arsed going to another pharmacy to get more paracetamol.

Solpadeine abuse is the biggest addiction problem in ireland outside of alcohol and cigarettes.

Ok but Tesco has no restriction on the amount of alcohol you can purchase. i.e. a person could buy just one bottle of whiskey and drink all of it in one go. That has a very high chance of death and if they but two bottles, its almost a certainty.

While I agree with your description on the severity of paracetamol if abused, your post does not explain the rationality of the policy.

I mean you can die if you drink 8 liters of water in a very short period.

you say "when the person realises they can't get 2 packs, they can't be arsed going to another pharmacy to get more paracetamol."

How do you know this? Do you have any link to a study?

Your post is a little contradictory, on one hand you demonstrate a scenario where a person is determined to end their life and chooses to do so with paracetamol but is "not arsed" to walk across the street.
That same individual has a far far higher chance of death with alcohol but they dont go this route because?

Are you saying a person is determined but irrational or determined and rational?

Also, what percentage of society are we talking about. What issues are in society that "asprin" needs to be locked up? As far as I know you cannot get a "high" from asprint.

We tolerate cars yet we know they kill ~ 300-500 people per year. How many people in Ireland are dying from paracetamol overdose / asprin overdose?

How many people die from alcohol?

Timberrrrrrrr

Pkiernan wrote: »

Try buying Sudafed in the US

Try buying a kinder egg lol

lawrencesummers

I have a lot of fun buying codeine for pain relief.
If the pharmacist says anything I say with a straight face that it’s for period pain.

I don’t have the apparatus for periods. They never question it further.

ygolometsipe

ygolometsipe wrote: »

Ok but Tesco has no restriction on the amount of alcohol you can purchase. i.e. a person could buy just one bottle of whiskey and drink all of it in one go. That has a very high chance of death and if they but two bottles, its almost a certainty.

While I agree with your description on the severity of paracetamol if abused, your post does not explain the rationality of the policy.

I mean you can die if you drink 8 liters of water in a very short period.

you say "when the person realises they can't get 2 packs, they can't be arsed going to another pharmacy to get more paracetamol."

How do you know this? Do you have any link to a study?

Your post is a little contradictory, on one hand you demonstrate a scenario where a person is determined to end their life and chooses to do so with paracetamol but is "not arsed" to walk across the street.
That same individual has a far far higher chance of death with alcohol but they dont go this route because?

Are you saying a person is determined but irrational or determined and rational?

Also, what percentage of society are we talking about. What issues are in society that "asprin" needs to be locked up? As far as I know you cannot get a "high" from asprint.

We tolerate cars yet we know they kill ~ 300-500 people per year. How many people in Ireland are dying from paracetamol overdose / asprin overdose?

How many people die from alcohol?

Aspirin isn't a pharmacy only medication. It can be bought in a supermarket. I have no idea why it would be behind a counter. Maybe, ask that pharmacist if you are concerned.

You seem to have very little understanding of what a person with suicidal ideation experiences when they have onset of impulsivity. Little breaks like this can be the step they need to try diversion techniques/ call someone.

It is difficult to take on board an amount of alcohol that could kill you in one sitting. Water would be similar.

By the time, your body reacts to high paracetamol levels in your body, it is too late. Vomitting won't help. The only treatment is IV acetylcysteine.

Here is a study that showed a decrease in paracetamol overdoses.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1831716/

lawrencesummers

lawrencesummers wrote: »

I have a lot of fun buying codeine for pain relief.
If the pharmacist says anything I say with a straight face that it’s for period pain.

I don’t have the apparatus for periods. They never question it further.

If you are buying co-codamol for pain relief. You probably need to get to the root cause of your pain. Especially if you have a "go to" strategy for obtaining said addictive substance.

odyssey06

AH answer: The rot set in when they rid of the cocaine in Coca Cola and banned laudenum.

ygolometsipe

Deleted User wrote: »

Aspirin...]

You are making conjectures that are not consistent.
You posted a study to the impact of paracetamol which I already stated
I agree with you so there was no need to post that but im happy if it helps other readers.

The study I asked you for was the one where you claim "when the person realises they can't get 2 packs, they can't be arsed going to another pharmacy to get more paracetamol"

I will suspend all discussion with you until you can prove this claim.

ygolometsipe

lawrencesummers wrote: »

I have a lot of fun buying codeine for pain relief.
If the pharmacist says anything I say with a straight face that it’s for period pain.

I don’t have the apparatus for periods. They never question it further.

I hope you know codeine is a very serious drug! it can lead you into real trouble.
I hope you are well, I wont judge you, you could be well capable of understanding it.

ygolometsipe

ygolometsipe wrote: »

You are making conjectures that are not consistent.
You posted a study to the impact of paracetamol which I already stated
I agree with you so there was no need to post that but im happy if it helps other readers.

The study I asked you for was the one where you claim "when the person realises they can't get 2 packs, they can't be arsed going to another pharmacy to get more paracetamol"

I will suspend all discussion with you until you can prove this claim.

The study suggests that the restriction on pack size has led to a modest reduction in suicide attempts with paracetamol/aspirin. This suggests by making obtaining the paracetamol/aspirin more difficult, it leads to a reduction in suicide attempts.

I don't know how I could simplify it for you more.

You can suspend the discussion if you like as you don't seem to be able to understand the data.

ygolometsipe

Deleted User wrote: »

The study suggests that the restriction on pack size has led to a modest reduction in suicide attempts with paracetamol/aspirin. This suggests by making obtaining the paracetamol/aspirin more difficult, it leads to a reduction in suicide attempts.

I don't know how I could simplify it for you more.

You can suspend the discussion if you like as you don't seem to be able to understand the data.

Did i say anything about packet size?

ygolometsipe

Deleted User wrote: »

The study suggests that the restriction on pack size has led to a modest reduction in suicide attempts with paracetamol/aspirin. This suggests by making obtaining the paracetamol/aspirin more difficult, it leads to a reduction in suicide attempts.

I don't know how I could simplify it for you more.

You can suspend the discussion if you like as you don't seem to be able to understand the data.

"It is the lack of statistically significant and consistent changes in the relative rates of deaths for paracetamol versus coincidental changes for other drugs (Table 4 in [1]) that lead the authors to conclude that the regulations may have had no effect."

ygolometsipe

ygolometsipe wrote: »

Did i say anything about packet size?

Limiting pack size/ number of packets. It leads to the same thing of restricting the amount of paracetamol that can be obtained in one go ergo more difficult.

I agree it's a bit paternalistic but it has an effect/ rationale behind it.

ygolometsipe

ygolometsipe wrote: »

"It is the lack of statistically significant and consistent changes in the relative rates of deaths for paracetamol versus coincidental changes for other drugs (Table 4 in [1]) that lead the authors to conclude that the regulations may have had no effect."

Read the conclusion, my good man.

What is the lesson for regulators in the UK and elsewhere from these studies on paracetamol regulation in the UK? We think they provide some further evidence that changes in drug availability and packaging can lead to reductions in deaths from self harm. However, the changes may be much less than anticipated if they cannot be enforced.

Morgan et al.'s study also indicates the benefits of having national databases on deaths from poisoning. These databases could be further strengthened by having more information routinely collected and regularly audited for accuracy. At the moment such databases are more than adequate for determining priorities for public health interventions but less than ideal for evaluating these same interventions. We would heartily endorse the authors' proposal to ensure that prospective evaluation is an integral part of such public health interventions. When this happens, we will know that evidence-based public health is more than just a slogan.


We can all pick one sentence to suit our agendas if you want.

ygolometsipe

I am not trying to pick a fight but if you make a claim, you need to back it up!
Your own study post claimed it made no different but I never brought packet size into the mix.

Anyway, like I say.....


The study I asked you for was the one where you claim "when the person realises they can't get 2 packs, they can't be arsed going to another pharmacy to get more paracetamol"

I will suspend all discussion with you until you can prove this claim.

Sarn

Here’s one that supports the restriction on pack size in the UK.

https://www.bmj.com/content/346/bmj.f403

odyssey06

The maximum pack size for paracetamol in ROI is 24... in the UK it seems to be 32.
Doesn't seem to have any basis in harm reduction.
Unless by harm you mean protecting cosy cartel of pharmacies here from competition

Pkiernan

Pkiernan wrote: »

Try buying Sudafed in the US

That’s nothing to do with protecting people etc it’s because the pseudoephedrine gets extracted to make meth.

You can buy a packet of 200 ibuprofen or paracetamol off the shelf no problem over there which would be unheard of in Ireland.

Ireland is overly strict though even compared to other European countries where you can get plenty off the shelf that’s prescription here (and far more expansive). There are pain killers I use that are prescription only and I can buy a box of 100 for pittance off the shelf in Spain.

SEPT 23 1989

ygolometsipe

odyssey06 wrote: »

The maximum pack size for paracetamol in ROI is 24... in the UK it seems to be 32.
Doesn't seem to have any basis in harm reduction.
Unless by harm you mean protecting cosy cartel of pharmacies here from competition

what is the maximum size for walking to another tesco?

odyssey06

odyssey06 wrote: »

The maximum pack size for paracetamol in ROI is 24... in the UK it seems to be 32.
Doesn't seem to have any basis in harm reduction.
Unless by harm you mean protecting cosy cartel of pharmacies here from competition

You think pharmacists make their money on selling paracetamol. I wish.

In all seriousness though, patient safety is front and foremost of my mind in my work as a pharmacist.

global23214124

My doctor prescribed me 100 pills of paracetamol for when i had a stomach bug a few months ago (along with relevant meds). Didn't realise it was so dangerous in high amounts. Didn't take much of it to be fair as the other stuff did the job but I'll be weary from now on.

endofrainbow

Timberrrrrrrr wrote: »

Try buying a kinder egg lol

https://www.standard.co.uk/news/world/the-us-is-finally-lifting-its-ban-on-kinder-eggs-a3691696.html

endofrainbow

global23214124 wrote: »

My doctor prescribed me 100 pills of paracetamol for when i had a stomach bug a few months ago (along with relevant meds). Didn't realise it was so dangerous in high amounts. Didn't take much of it to be fair as the other stuff did the job but I'll be weary from now on.

to be fair you'd be weary if you did take too much.

Pharmacists will tell you about taking too much paracetemol when dispensing plus there's warnings on all labels

odyssey06

Deleted User wrote: »

You think pharmacists make their money on selling paracetamol. I wish.
In all seriousness though, patient safety is front and foremost of my mind in my work as a pharmacist.

That's a good attitude re: patient safety.

But when 32 pack generic paracetamol is selling for less than 1 pound in N Ireland and a 24 pack here sells for €2.50 someone is making money on it and neither the patient's wallet or safety is coming into it.

odyssey06

endofrainbow wrote: »

to be fair you'd be weary if you did take too much.
Pharmacists will tell you about taking too much paracetemol when dispensing plus there's warnings on all labels

I think the bigger risk is buying paracetamol and another product which contains it... Fair chance many customers don't realise the other product contains paracertamol.

ygolometsipe

Water John wrote: »

One over dose of paracetemol can damage you liver TMK. Takes a long time drinking alcohol to achieve that.

so your saying a person that drinks 1500ml of alcohol in 1-5 minutes(chuging) is less damaging than paracetemol? How do you know this?

When you say "Takes a long time drinking alcohol to achieve that" you seem to be equating (paracetemol) "abuse" with "normal" alcohol consumption levels which are obviously not equal.

abuse of any drug is dangerous, I just cannot understand way one legal and deadly drug can be bought without issue but something like a (parama validated non drowsy histamine like zertec) can only be bought in the pharmacy.

I mean how can zertec or asprin harm you? even "dioralyte" an electrolyte is in the "locked box".

am i really naive or can these things really be abused? I really don't know.

is pharmacy policy telling me, your all crazed drug fiends that need everything to be locked away? even things you literally cannot get high off?

I mean how can you abuse eletrolytes?

ygolometsipe

ygolometsipe wrote: »

so your saying a person that drinks 1500ml of alcohol in 1-5 minutes(chuging) is less damaging than paracetemol? How do you know this?

You are almost guaranteed to puke the alcohol up if you can even get it down in the first place.

global23214124

global23214124 wrote: »

My doctor prescribed me 100 pills of paracetamol for when i had a stomach bug a few months ago (along with relevant meds). Didn't realise it was so dangerous in high amounts. Didn't take much of it to be fair as the other stuff did the job but I'll be weary from now on.

It's fine as long as you don't take more than 8 tabs a day.

ygolometsipe

ygolometsipe wrote: »

so your saying a person that drinks 1500ml of alcohol in 1-5 minutes(chuging) is less damaging than paracetemol? How do you know this?

When you say "Takes a long time drinking alcohol to achieve that" you seem to be equating (paracetemol) "abuse" with "normal" alcohol consumption levels which are obviously not equal.

abuse of any drug is dangerous, I just cannot understand way one legal and deadly drug can be bought without issue but something like a (parama validated non drowsy histamine like zertec) can only be bought in the pharmacy.

I mean how can zertec or asprin harm you? even "dioralyte" an electrolyte is in the "locked box".

am i really naive or can these things really be abused? I really don't know.

is pharmacy policy telling me, your all crazed drug fiends that need everything to be locked away? even things you literally cannot get high off?

I mean how can you abuse eletrolytes?

Aspirin is quite a dangerous medication. Can lead to massive GI bleeds.

ygolometsipe

Dangelo Itchy Crossbones wrote: »

You are almost guaranteed to puke the alcohol up if you can even get it down in the first place.

you see "are almost guaranteed" is a claim, anyone can make a claim.

https://www.irishtimes.com/news/man-died-after-10-shot-party-trick-1.875864

I remember this case because it really shocked me at the time, the barman was charged with manslaugher for poring the stated size of whiskey.

Also when you say "puke" it up, that's actually the most common way to die from alcohol. you puke in your sleep and drown.

ygolometsipe

Deleted User wrote: »

Aspirin is quite a dangerous medication. Can lead to massive GI bleeds.

The study I asked you for was the one where you claim "when the person realises they can't get 2 packs, they can't be arsed going to another pharmacy to get more paracetamol"

I will suspend all discussion with you until you can prove this claim.

lawrencesummers

Deleted User wrote: »

If you are buying co-codamol for pain relief. You probably need to get to the root cause of your pain. Especially if you have a "go to" strategy for obtaining said addictive substance.

I probably don’t need to get to the root cause. I know full well what the root cause is.

ygolometsipe

ygolometsipe wrote: »

The study I asked you for was the one where you claim "when the person realises they can't get 2 packs, they can't be arsed going to another pharmacy to get more paracetamol"

I will suspend all discussion with you until you can prove this claim.

https://academic.oup.com/qjmed/article/105/1/41/1558109

Look, you extrapolate the point from the reference sources I've provided. It's not my fault for your lack of understanding/ignorance.

ygolometsipe

Ashlyn Flabby Accountant wrote: »

That’s nothing to do with protecting people etc it’s because the pseudoephedrine gets extracted to make meth.

You can buy a packet of 200 ibuprofen or paracetamol off the shelf no problem over there which would be unheard of in Ireland.

Ireland is overly strict though even compared to other European countries where you can get plenty off the shelf that’s prescription here (and far more expansive). There are pain killers I use that are prescription only and I can buy a box of 100 for pittance off the shelf in Spain.

Pkiernan & Alec Worried Shredder do you mind explaining this a bit more. your saying you cannot buy Sudafed because its used in drug making?

I listen to Joe Rogan+others and they frequently talk about taking over the counter sleeping pills so I don't understand why sudafed would be an issue.
i just googled it (sudafed).

Also Pkiernan if your in the usa, is it true that in states where cannabis is only medically legal, the weed shops employee doctors to sign "prescriptions" or is that nonsense?

ygolometsipe

Deleted User wrote: »

https://academic.oup.com/qjmed/article/105/1/41/1558109

Look, you extrapolate the point from the reference sources I've provided. It's not my fault for your lack of understanding/ignorance.

It's not my fault

I never said anything was your fault. don't be mean! these's no need to insult my intelligence "your lack of understanding/ignorance"

for all else see my previous post.

odyssey06

ygolometsipe wrote: »

Pkiernan & Ashlyn Flabby Accountant do you mind explaining this a bit more. your saying you cannot buy Sudafed because its used in drug making?
I listen to Joe Rogan+others and they frequently talk about taking over the counter sleeping pills so I don't understand why sudafed would be an issue.
i just googled it (sudafed).
Also Pkiernan if your in the usa, is it true that in states where cannabis is only medically legal, the weed shops employee doctors to sign "prescriptions" or is that nonsense?

Sudafed can be used to make methamphetamine \ crystal meth by amateur chemists.

Sarn

Pseudoephedrine in Sudafed is used to make crystal meth which is why it is prohibited in certain countries.

odyssey06

odyssey06 wrote: »

Sudafed can be used to make methamphetamine \ crystal meth by amateur chemists.

Via the red, white and blue method.

I used to work in a library, where people asked all sorts of queries. On the 1980s a lady (of not much education) brought in two different brands of paracetamol she had got in a then dodgy pharmacy (long since closed down) and was going to take the tablets simultaneously. She wanted a second opinion about the wisdom of taking such as she lived alone and had nobody else to ask. I knew of the acute damage to the liver it could do and told her immediately never ever to take two brands of paracetamol simultaneously and to scrutinise packets of medicines closely and read the info. There were far fewer regulations back then. The lady then told me she already had severe liver problems. The fact that regulations have become ever more stringent can only be a good thing and must have saved quite a number of lives. That lady lived many more years and always thanked me for pointing out the dangers of the medicine.

ygolometsipe

odyssey06 wrote: »

Sudafed can be used to make methamphetamine \ crystal meth by amateur chemists.

ok that really makes sense!

so do you think the reason these seemingly simple drugs like
asprin/dioralyte(there just my WFT examples, like I cannot see anyway they can be abused)
are use to make serious drugs?

That actually would really explain it and if that is the case then fair enough, you would have totally answered my post!

my only question (any you don't have to mention any specifics)
is it really possible to get something out of zertec ?

like how? ok lets just say its drowsy but booze is drowsy. why cant you buy zertec in tesco or dunnes?

odyssey06

ygolometsipe wrote: »

ok that really makes sense!
so do you think the reason these seemingly simple drugs like
asprin/dioralyte(there just my WFT examples, like I cannot see anyway they can be abused)
are use to make serious drugs?
That actually would really explain it and if that is the case then fair enough, you would have totally answered my post!
my only question (any you don't have to mention any specifics)
is it really possible to get something out of zertec ?
like how? ok lets just say its drowsy but booze is drowsy. why cant you buy zertec in tesco or dunnes?

The effects of alcohol are well known \ publicised.
We have drink driving laws.

I don't have a definitive answer re: antihistamines.
In and of themselves they should be harmless.
But they do have subtle contra-indications with other medicines which may not be knownÞstood by the average purchaser.
Also, first generation anti-histamines were drowsy and it could be the regs haven't been updated because there's been no push for it.

Dioralytes. I remember ALDI selling electolytes which are the same really.
The reason could be as mundane as supermarkets don't regularly stock it not for legal reasons but because they don't see a market \ markup in it.

Aspirin... actually the more I think about it these have way more side effects and contra-indications than paracetamol.
On reflection, it probably shouldn't be sold in supermarkets.

ygolometsipe

Deleted User wrote: »

I used to work in a library...

wow! that's unreal! I think this is a good story, you should be very proud!!!

I'm a mathematician/computer scientist by profession. i know were considered "cold" but i started this post because the scale of regulation in a pharmacy is just odd to me, now if something is odd to me, then its really really odd. so I just want to know how other people feel about it.

ygolometsipe

ygolometsipe wrote: »

wow! that's unreal! I think this is a good story, you should be very proud!!!

I'm a mathematician/computer scientist by profession. i know were considered "cold" but i started this post because the scale of regulation in a pharmacy is just odd to me, now if something is odd to me, then its really really odd. so I just want to know how other people feel about it.

Patient safety is odd to you?

ygolometsipe

odyssey06 wrote: »

...

can i assume your a pharmacologist?

so in your last post you seemed to indicate aspirin has correlating effects.
I totally understand that but how do you balance that with statistical knowledge of average drug abuse in Ireland?

do you medically just pretend its not real?

otherwise your telling me the average irish person has a "known" interaction to all medication? where is the data?

How can you tell if they did 100 lines of whatever and/or cant have access to x?

does that make sense?

odyssey06

ygolometsipe wrote: »

can i assume your a pharmacologist?
so in your last post you seemed to indicate aspirin has correlating effects.
I totally understand that but how do you balance that with statistical knowledge of average drug abuse in Ireland?
do you medically just pretend its not real?
otherwise your telling me the average irish person has a "known" interaction to all medication? where is the data?
How can you tell if they did 100 lines of whatever and/or cant have access to x?
does that make sense?

I'm not a pharmacologist... maybe that's why I don't fully understand your questions!

What I will say if I am not approaching it as an expert.

I am approaching it from the perspective of the average citizen and what are the likely gaps in their knowledge when it comes to medicines.
Or even, me as a 20 year old.
I knew that taking too many paracetamol, or way over the dosage of any medication is risky.
I knew that there is a limit to how much alcohol you can handle and also its effects in relation to driving, operating machinery etc

What I didn't know... and wouldn't know buying these meds in a supermarket:
That paracetamol was also in other OTC medicines.
The difference between first and second generation antihistamines, and their interactions with other meds.
That you shouldn't take sudafed going to bed.
The effects of aspirin & ibuprofen on stomach v paracetamol.
The effect of aspirin in relation to other meds, or on blood thinning.

Some of the above you weren't informed about in pharmacies back in the day...