Hey Lifehacker, When I have a raging headache and I go to the chemist for some Nurofen Plus, the last thing I need is for some teenager to interrogate me about what I need them for. As far as I’m concerned it’s none of their business whether I intend to take them as directed or freebase them in a primary school playground — I’m an adult purchasing a legally-available product. What are my rights and responsibilities in this situation, and can they refuse to sell them to me if I give an answer they don’t like? Thanks, Just Give Me The Drugs
Pharmacy refusal picture from Shutterstock
Dear JGMTD,
This annoys me too. I used to be convinced that my pharmacist thought I was a drug addict until my wife assured me I look “too well-fed” to ever be mistaken for a junkie. Thanks for nothing, sweetheart.
Over recent years there have been growing concerns about the misuse of products containing codeine which is an addictive methylated morphine. Excessive codeine consumption can lead to a range of medical issues including gastro bleeds and kidney problems.
In 2010, the National Drugs and Poisons Schedule Committee introduced tighter controls for non-prescription codeine products in a bid to combat harmful overuse. In addition to new warning stickers on packaging, pharmacists are required to quiz customers about their familiarity with the drug.
This generally involves querying if you’ve used codeine before and the type of ailment that’s troubling you. The pharmacist may also recommend that you restrict usage to three days and suggest a visit to your GP if you’re a frequent repeat-customer.
In most cases, the questions will be polite and brief. If you feel like you’re being interrogated, it could mean one of two things — either the pharmacy has a terrible bedside manner, or they’ve noticed you’re buying too much codeine.
We asked our local pharmacist whether the answers a codeine customer provides actually make any difference to the purchasing outcome. She said that pharmacies are under no obligations to sell codeine products to a customer who gives an answer they don’t like. (This isn’t anything unusual — most retailers reserve the right to refuse service even when their products aren’t potentially harmful.)
In other words, telling them you plan to use it to supplement your heroin addiction is probably a bad idea.
Cheers
Lifehacker
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Comments
50 responses to “Ask LH: Why Do I Get Quizzed When I Buy Painkillers?”
oh no, a pharmacist is making sure I am not misusing a potentially dangerous drug! My rights are being infringed upon! Call my lawyer, maybe I can sue ’em!
Pharmacists go through quite a bit of training so they better understand what they are giving someone. they are highly knowledgeable over a very, very, wide range of products. and just like any doctor who doesn’t want to see your disgusting rash, they do it for YOU and your own safety.
Codeine is not only highly addictive it can be very harmful when misused. I would be very concerned if the pharmacist didn’t try and ensure I am using the best product for my condition.
If you really dislike it, then register for the eHealth personal health record so they can just look up your file rather than going on face value.
Or maybe you should get some antibiotics for your common flu……. what could go wrong, you obviously know whats best!
Antibiotics and flu??? I don’t think so. Hope you’re not a pharmacist.
I think that was the joke
Yeah wth, get over it people. They’re just checking you know the ins and outs, making sure you’ve used it before etc.
My local pharmacist is always trying to push placebos onto people. Un-proven homeopathic rubbish shouldn’t be allowed to be sold along actual medicine.
Your pharmacist should be banned from trade.
The reason they are peddling it is it has higher profit margins for them. And they know there are no side effects since they are completely f*cking inert.
But any pharmacist selling homeopathic products on their shelves, or worse – actively recommending it – are breaching their patients trust. Furthermore, if they make _any_ claims about their effectiveness, they should loose their license – for being either (a) a bald-faced lair, or (b) a terrible scientist.
Anyone serving alcohol is required to make very similar assessments as part the RSA system.
It only makes sense that this system be implemented for painkillers, too!
This is typical of a nanny state. Instead they should be warning you about the potential dangers of misusing it then let you make a decision like the big boy (or girl) you are.
Unfortunately medications taken outside of their prescribed or indicated use then makes it illegal use. Pharmacists are also obligated by law to ensure that there is a therapeutic need when selling codeine products, and are practicing outside of their scope if supplying it without doing so.
While I agree that codeine is potentially harmful, I can also see the asker’s viewpoint.
I suffer from migraine and cluster headaches – migraine can be helped by codeine based drugs (cluster headaches can’t). The last thing I want when I can’t see out of one eye, I am bent over like a 90 year old and can’t barely speak is to have to discuss my use of these meds…
You need one of two things:
1. a pharmacist who knows you, recognises you are in pain and will push the drugs to you along with a glass of water to help you as much as he or she possibly can (Nowadays – given turnover of staff etc – this is not likely to happen unless you are in a small town)
2. Some preparation and a stash of drugs at home/work/in your work bag/in your car/wherever else in order to be prepared rather than having to go through this pain (and I mean the interrogation, not the migraine).
Worse is if you end up in emergency (as I have) and they LITERALLY treat you like a junkie (I’ve had nurses check between my toes for injection marks….)
But if 1 and 2 are not possible in a certain case – a couple of stupid questions are the least of your worries…. Suck it up, get the drugs and get some relief.
FYI, Codeine isn’t recommended for migraines. Please hear me out.
first line treatment is actually soluble asprin, and if asprin can’t be used then it’s ibuprofen /paracetamol. However, the reason most migraine sufferers don’t feel like they are getting any benefit is that they are not taking a sufficiently high enough dose for migraines.
soluble asprin is 900-1200mg (which is 3-4 tabs)
ibuprofen is 600mg (which is 3 tabs)
paracetamol is 1500mg (again 3 tabs)
in all three cases you still need to adhere to the max daily dose.
But here is the kicker, migraine causes nausea in some people this is due to migraine causing gastric stasis, by taking codeine you slow down your GIT, and as a result can make nausea worse, and the double action of slowing down the GIT also reduces the effectiveness of the pain relief as it is absorbed slower.
Now here is the other kicker, normally with asprin and ibuprofen, for pain relief you would be told to take them with food to reduce stomach upset. But for migraine you will be told to take it without food to speed up its absorption and therefore speed up the onset of pain relief. (obviously, those who suffer from gastric ulcers will be advised to take paracetamol as an alternative to these two).
I understand, when you have a migraine the last thing you want is to listen to me try and tell you this long winded *cough*, you want what you know (from your own experience) has worked for you in the past, and you want it NOW. I totally understand, but we don’t spend 4 years studying pharmacology and all these drugs to try and be a drug cop. We are in fact “licenced drug dealers” with a goal QUM = quality use of medicines.
thanks for reading (if you got this far).
Agree. I get sinus headaches well maybe. Codeine hasn’t been working so now they’re thinking it’s migraines.
And ibuprofen does work but at a 3-4 tablets at a time. I was recently put on anti inflamitories for a knee injury and now no more headaches.
Yes – I agree codeine is shit for migraine – I normally take stronger-but-still-over-the-counter-drugs like mersyndol. For which I also get quizzed. But lots of medicines have codeine in them like mersyndol – but the codeine is not the main reason for taking it (the doxylamine succinate is).
I hear you there. I sometimes suffer nasty headaches and the only thing that I can get to rid the pain is either prescription panadeine forte or over the counter stuff in a higher dose. My mother is the same she has 3 prolapsed discs in her back, it pisses me off when the 18 year old behind the counter at the pharmacy is literally accusing you of buying these for some addict and not yourself. Since that’s how they treat anyone around here it would appear.
It annoys me also, but it is because of stupid people who abuse it.
The people abusing it is going to make it worse for the people that actually need it.
eg
“Melbourne researchers combed a decade of Victorian coroners’ data and found 115 cases in which codeine and ibuprofen were both detected, including 63 examples in which drug toxicity was the cause of death.”
http://www.theage.com.au/victoria/call-for-action-as-115-deaths-linked-to-pain-pills-20130918-2tyw0.html
It is also good to note that Codeine is banned in many countries. Not only is it legal in Australia, but we can actually buy it without a prescription. A lot of people travel with Codeine products may actually be importing medication which is classified as an illegal drug.
So the questions are a minor inconvenience considering how hard it could be.
I regularly feel a bit miffed when I buy Sudafed, for much the same reason. Most chemists are part of a voluntary scheme to take down your name & address and see some ID when you buy a product containing pseudoephedrine… in this case mostly because of the illegal use of the product to make illegal drugs.
As someone who regularly needs the real sudafed for sinus related problems, I wonder when I’m going to get a visit from the feds to smash my secret backyard drug lab. Breaking bad. That’s me.
But I get the purpose of it. For this, in particular, it’s appropriate for chemists to check, in the interests of the health of the customers, and for the control of addictive substances.
Nanny state? Maybe, but you only used to be able to get 8mg codeine products over the counter, and the 40mg versions required a script. Now that there are 15mg versions available without a prescription, it seems fair to have a moderate level of health professional control.
Are prescriptions Nanny state @thecog? It’s all a matter of perspective I suppose. But addiction affects the whole of society – not just the individual concerned – so it seems to me that society has a right to implement some minor checks.
I’m pretty sure this scheme isn’t voluntary.
The industry may have voluntarily adopted it (to avoid the government forcing them into a harsher scheme) – but I don’t think your pharmacy has any choice in their adherence to the scheme.
Yep: Project Stop is definitely not voluntary.
It’s a voluntary scheme of the Pharmacists Guild. If a Pharmacist chooses to participate, then they may not supply you with these drugs without ID from customers. A pharmacist must determine genuine therapeutic need before issueing pseudoephedrine based products, and so if they want to take your ID, and check it against a database to ensure you’re not exceeding healthy use, they have the right to do so. It’s not optional for the customer if the pharmacist uses this method, but it IS optional for the pharmacy.
http://www.projectstop.com/index.html
Pseudoephedrine is a S3 Recordable drug. Every sale must be recorded, with records available to inspectors and/or police if required. Whether a pharmacy decides to use Project Stop or another program/method is up to them (to an extent), but Project Stop has been strongly recommended because of it’s real time recording and ability to prevent smurfing (pharmacy shopping and illegal diversion) which was the main issue with pseudo in the past.
Please refer to the Poisons and Therapeutic Goods Regulation 2002 (NSW).
The pseudoephedrine thing pisses me off the most. I don’t get hayfever often – unlucky if it’s twice a year – but when I do, their pathetic replacement is more pitiful than a placebo.
And unfortunately, thanks to the crime rates and reputations of the areas I live and work, pharmacists don’t even stock the real stuff. It’s just not available, not even with a prescription.
That’s usually about the point where I start raging about nanny states – when all this worrying about what someone else is going to do interferes with ME getting help with a problem which WOULD be available if other people weren’t assholes. Rationality takes a back seat to getting good and angry when you’re all gummed up like that. I don’t care about crime rates or people taking recreational drugs or pharmacy break-ins, all I care about is that some *@#% is standing between me and sweet, merciful relief, which makes them complicit in my suffering.
Possibly not entirely unwarranted, though. Hell… I remember when I was working 70+ hr weeks (young and stupid and needed the money), dying on my feet from lack of sleep but trying to power through it, and complaining to my local pharmacist, “Are you telling me the strongest thing I can get is caffeine pills?! I’m mainlining energy drinks, you could bottle my urine and no-one would tell the difference, what is a pill of it going to do? Surely with all the advances in modern medicine we’ve been able to figure out SOMETHING more effective than a glorified coffee-pill!”
And the pharmacist replied, “Yes, we have. It’s called speed.”
“Oh. God… dammit.”
You can bet your ass if I could’ve bought it from the chemist I would’ve, at that point.
YES. Non pseudo allergy tablets fucking SUCK. Ugh. I don’t even see pseudo based allergy tablets anymore, which sucks for me since I suffer from chronic allergies which could be knocked on the head for a day or more within 30 minutes of taking the pseudo based tablets and I would sometimes only need half not two like these shit ones I have require at 180mg of whatever the active ingredient is :/
Pseudoephedrine is available at most chemists, but it’s hidden and you need to have a good reason to need it, as opposed to the ‘inferior’ phenylephrine. Studies show it to be equivalent, but I am yet to find a patient that feels that way…
Phenylephrine has a high first pass metabolism through the liver…therefore most of it is excreted before it can be effective. This is why it is useless.
I know there’s a difference between drug metabolism and dietary metabolism, but I wouldn’t be surprised if there’s still enough variety between different people’s metabolic rates to make a difference (and coincidentally be ruled out as an anomaly on most studies – after all, how often do you get lucky genetic freaks as a majority)? Reckon Pharmacy101 down there might have the right of it.
There’s no inverted commas needed. The PE formula is provably inferior for the only sample size I give a shit about: me.
No mention of ProjectStop? Where pharmacies record your driver’s license into a national database when purchasing pseudoephedrine based drugs? As per their website, http://www.projectstop.com:
Project STOP operates in the following way:
– Upon requesting a pseudoephedrine-based product, your pharmacist asks to see an acceptable form of photographic identification (see below).
– Your pharmacist records your identification card number in a protected database held and operated by the Pharmacy Guild of Australia.
– Your pharmacist also records the name of the product and the quantity you have requested in the database.
– The database checks to see if your identification number was previously entered into the database within an appropriate threshold period.
– The pharmacist decides whether or not to supply the product based on a determination of your therapeutic needs.
– The database records whether or not the sale was made.
The reader’s question was specifically about Nurofen Plus, which doesn’t contain pseudoephedrine. A wider article about various drug restrictions within pharmacies isn’t a bad idea though. Watch this space…
Neurofen plus. just go into any woolworths and use the robot checkout if you don’t like questions.
Sadly you can’t buy Neurofen+ in woolies/Coles, only plain Neurofen (I know.. I’ve looked). You can only buy it at a chemist.
Nurofen PLUS icant be bought from supermarkets. Only plain nurofen (which does not contain codeine).
Nurofen PLUS cant be bought from supermarkets. Only plain nurofen (which does not contain codeine).
Nurofen PLUS contains codeine. Any product containing codeine fall under the category of Schedule 2 or above as per the Australian Government’s Therapeutic Goods Administration. Schedule 2 medications can only be sold in pharmacies; you’d be lucky to find any in Woolies.
Nurofen Plus is a schedule 3 drug: a pharmacist must be involved in the provision of it: hence all the questions.
You make an interesting point. Ibuprofen (Nurofen) should not be available from supermarkets at all!!! The inappropriate use of NSAIDs result in a significant number of hospital admissions each year at the expense of the taxpayer. This is before even debating the use of codeine.
Pharmacists have a responsibility to ensure the drugs they dispense are indeed correct and safe.
If your pharmacist “grills” you, consider yourself lucky. Your pharmacist is providing the care for you, which is exactly what they are supposed to do. I have seen the damage done by pharmacists who do not care. Believe me , a series of questions is much better , then ending up on dialysis because your pharmacist does not do their job.
Please get a pharmacist or similar to do that pseudo article chris, as there are gaps in knowledge regarding somethings pharmacy related; it’s a mess of state and federal laws, professional obligations and ‘business’ pressures.
I think you may find that the chemists are required to first ask specific questions and to give advice depending on the answers to a wide range of drugs that controlled but don’t need a prescription. Also there are many drugs now available that not so long ago were prescription only.
If its too hard to answer a couple of questions so the pharmacist can give advise as they are required to then perhaps we should go back to the prescription only system and the doctor can advise you of the dangers and recommendations. One off the most common reasons for controlling the drugs is to minimise overconsumption and prolonged use and other related dangers to the specific drug being requested.
Oh and just off topic a little is you can fail a drug test with codeine in your system and also some of the other drugs that are controlled by the pharmacist.
Lastly there has been a tug of war for some years now between doctors and Pharmacists to make available without prescription the drugs that you are now being asked questions about by the Pharmacist so get over it and be happy you no longer require that prescription that is the real pain in the bum and the pocket.
Have a nice day.
So many armchair experts. There are so many things a pharmacists checks with a few simple questions. Why not just take Nurofen if you have a history of heart attack? It only increases your risk of death. Or how about maximum dose Voltaren with an active duodenal ulcer? Hello hospital admission.
Pharmacists don’t come to your work telling you what to do, I suggest you return the favour.
I graduate in less than 6 months, and have worked in pharmacies for a few years.
legally, we are required to ensure there is a “therapeutic need” to supply any drug s3 medicine (over the counter products), codeine based products like nurofen plus qualify here. Note, we dont have to ask you for any S4 (prescription) meds as its assumed the doctor has done that already.
Secondly, if the pharmacist is a good one, they will generally try and make sure you are getting the best medicine for your problem. We cannot assume that you know it all, and have had it a million times. Eg, if someone is coming in for nurofen plus 2 times a month, for headaches and migraines, they probably have bounce back and are getting it from the nurofen itself (good luck explaining that one to a junkie)
So in summary, legally we have to ask and ensure theres a need, secondly were trying to help you, but as time goes on, it gets harder and harder to do so, as people like yourself and many others, could not give two shits about what we have to say and just want the meds as “you know best”
p,s
As far as project stop goes, a bunch of pharmacists got in strife for recording in tasmania, that as far as i read was illegal. as the DoHA said it was only to be used for pseudoephidrine, and not to be “scope gaining” into other products.
Cardiology pharmacist also makes a sweet point
We ask questions about codiene products so that people are:
1. not taking a drug that will interact with any of their medications or disease states and
2. Aren’t using a medication too often thereby causing harm to their stomach, renal system or liver also if they are havng to use tooo much it may be due to the codine products being ineffective and therefore another medication would be better suited to that particular patient. Codine is in some people not converted to its active form at all and would not be of any benifit to these patients
As for project stop it is to stop people that make pseudo into ice and speed so unfortunatley in this case the people who are abusing it ruin it for everyone making you have to hand over your licience and wait for it to be processed
Sadly I have had a chemist interrogate me because I was getting VENTOLIN! The reason why, because I lost my last puffer. I ended up getting the 5th degree about my asthma plan despite me repeatedly telling them my RESPIRATORY SPECIALISTS coordinated my plan and it was recently reviewed as still effective for me and I was happy with it because it was working the only reason I was getting it because it was LOST so I wanted one replacement and one backup to leave at home.
They started lecturing me and I ended up just replying, yes my doctor and I already talked about this and yes I know about asthma I only did a post graduate degree in respiratory science. I was about to walk out on them and have never gone back. I got less trauma when I got several of my scripts for long term opiates filled at once back in the day. The only issue I had getting them was they didn’t have enough to fill up front so gave me what they had and rang me later. Seemed kinda ass backwards that the very scary drugs got no more then the quick query to make sure I was knowledgable about the meds vs upsetting. I don’t mind them asking but when you your only crime is being forgetful and you are trying to be responsible by getting a back up just because you think everyone should be using preventers does not mean you need to hold my ventolin for ransom if I don’t sit and listen after I said yes thank you my specialist who knows my extensive history is aware of all of this because he told me to do it this way.
Common sense should dictate sales of OTC medicines (esp short-acting beta-agonists). Lost puffer and respiratory action plan should result in a speedy supply. I am surprised you were “interrogated” in this respect. However, one thing that you should be aware of if you did a degree in respiratory science, is that inhaler misuse and lack of understanding is rife throughout the community. Reliever overuse can result in a beta-receptor tolerance making it less effective when it is required. A majority of patients do not understand their inhalers, when to use them or how to use them…..it is a scary prospect.
With respect to your prescription issue…..this is not “ass backwards”. You have a prescription and have been assessed medically. Can I ask did you get “interrogated” by the doctor when the script was written or did you just walk in, demand it and a script was written?
Interestingly you bring respiratory issues into the discussion…..it is worth pointing out to those who are concerned regarding questions about Nurofen plus…..that anti-inflammatories can induce bronchospasm. Another reason why questions should be asked at the point of purchase.
Both were scripted (yes I know I can get ventolin unscripted, but I strangely like to have my doctors knowledge on most of my purchases except in dire circumstances and I generally don’t leave myself so bad. My asthma is highly controlled and I rarely get anything more than a mild attack associated with illness. So yes in my case the script that I could get OTC I got far more guff over compared to multiple high dose pain killers. I did listen to the chemist with the ventolin at first and answered their questions happily. It was when they didn’t stop and implied a lot of things despite my answers. I have no issue with being queried and asked, in fact I am for it. However I was 1 minute away from asking to see their manager I was so affronted by their attack and by them refusing to listen to my 10 years of excellent management that lead to me only needing a just in case inhaler which was what I was replacing after I moved house 3 times in 1 month. So yes I am usually better but it was a stressful time.
As for the doctor no, after 20 years with the same GP who has seen me through 3 brain surgeries and is in contact with my pain doctor he had no issue giving me the repeats I needed. As I was still post surgery that is why I had multiple high levels of narcotics. Everything was above board as you can imagine seeing doctors have to call to be allowed to prescribe that level of medication. I would have thought that I would have had less issue getting one prescription like ventolin compared to 5 massive doses even just on the interaction side. Not to imply the pharmacist with the pain meds didn’t do his job, he was just more concerned about getting me what I needed because he appreciated I needed it and just double checking quickly I was knowledgeable with these meds and if I wanted more info. To which I said what I knew and he was happy when I declined additional info because I already covered it. He LISTENED to me and didn’t assume as you said I am someone who knows nothing so talked over me. I know it happens, that is why you listen to the persons response and don’t make assumptions.
Just emphasises the ignorance of the public. Just because it is available over-the-counter does not make it safe….a common misconception. This is not an issue of misuse of codeine but an assessment of the presenting complaint. “I am an adult purchasing a legally available drug”…..it is only legally available if it is deemed appropriate by the Pharmacist. My apologies that the poison’s act does not have a section about your inconvenience.
This annoys the hell out of me simply because the chemist in my area has a backdoor which the methadone users have to go through. The same damn people have used this door for YEARS. How is that “therapeutic need”????
And I get twenty damn questions and not even the product I want. (I’d prefer not to have my Sudafed with Paracetamol in it because of reasons)
My methadone patient was swallowing 90 nurofen plus a day to feed a habit formed over many years … All starting out treating his migraines. 2 stomach ulcers later he woke to the realisation he was a junkie (how it took that long beggars belief). He can’t stop suddenly, he could possibly die of withdrawal, at best shit himself and have a seizure; so they are put on methadone to slowly reduce his does. There lies the therapeutic need. Your 20 questions to buy nurofen plus, is to prevent you becoming this person
I can see your point with that one.
The people I am referring to are people I know from having lived in this town my whole life, and who are drug users, who will use whatever they can get their hands on. The fact they can continue on the methadone program whilst also using meth, pot, heroin, is disgusting. These people have been on the program for at least 7 years. Why?
I get so dam angry being quizzed from a teenager that’s been lucky enough maybe of never even having a headache.. and how bloody dare the chemist ask me my symptoms even wen iv taken a Frign Dr’s script in to be filed. I went to get cold and flu pills yesterday ,WELL off she goes asking questions mmm you would have thought by the sneezing and raging temperature ephod have been so dam obvious instead it saying to me , are they for you how many times do you take them and to add insult to injury ,I get and what are your symptoms ,by this stage I’m ready to drag her over the bench and show Hey exactly how I’m feeling, but instead I looked her square in the eye and said ARE YOU FUCKING BLIND, I’m here for COLD AND FLU tablets , which started a man standing behind me going off and he said ,well just look at her she Looks like hell , really made my day haha .. Anyway I went to another chemist and she didn’t ask me a thing so I guess the man standing behind me was right lmao.
I am one of those young pharmacy assistants that you absolutely detest and I assure you that we HAVE to ask you those questions, we don’t ask them to impose judgment on your purchases or to piss you off. While I can’t speak for everyone who works at a pharmacy, we try and use common sense and where possible, not overload you with questions.
Many pharmacies are part of the QCPP program and assistants are obligated to undergo training where we are instructed to ask certain questions. The pharmacy is sporadically mystery shopped and if we just hand over Nurofen Plus (no questions asked) we will be marked with a big fat fail. This doesn’t even take into account our duty of care. You would be surprised about how many people are COMPLETELY misinformed about certain medicines or unaware of a drug interaction. As you can imagine it poses a liability if we sell a product and a person suffers medical complications as a consequence. Just today somebody requested Nurofen Plus but after probing I found out that he was also experiencing severe acid reflux, not a good match!
I understand that you know what is best for your own medical condition, but that doesn’t mean that EVERYONE does and as a precaution we just have to ask everyone these slightly inconvenient questions. Nobody is judging you, trust me we really don’t care if you are buying paracetamol or you are buying a fit – everyone is treated equally based on the situation. You may want your right as an adult to select medication, but can you imagine the implications of just handing out medications to anyone without a second thought?