Since July 2020, the GPhC has taken enforcement action against 36 pharmacy premises and a pharmacy professional following intelligence-led inspections or investigations relating to unusually high sales of codeine linctus.

Codeine linctus, classified as a Pharmacy (P) medicine under the Medicines Act 1968 and the Human Medicines Regulations 2012, can be only be sold without a prescription from a pharmacy, under a pharmacist’s supervision. The medicine, which can be used for a dry cough, is high risk because of well-known problems associated with its misuse, abuse or overuse.

The pharmacies involved were not adequately identifying and managing the risks associated with obtaining or selling codeine linctus. Unannounced inspections identified that appropriate safeguards were not always in place to ensure sales were managed safely and appropriately. The GPhC said “There were often insufficient controls to prevent repeat sales or to identify trends in requests. In some cases, repeat sales were even made knowingly to the same people.”

Following these inspections, the pharmacies had conditions put on their registration that they must not sell or supply any codeine linctus preparations to anyone without an NHS prescription. A warning has also been issued to the superintendent pharmacist and regular responsible pharmacist of one of the pharmacies involved. The individual was found to have allowed the supply of codeine linctus without sufficient checks and safeguards and relying on questionnaires and limited clinical information. Fitness to practise investigations continue into other superintendent and responsible pharmacist implicated in similar failings.

Claire Bryce-Smith, Director of Insight, Intelligence and Inspection said:

“Opioids are a high-risk medicine with potential for abuse. We know that across Great Britain most pharmacies and professionals have appropriate safeguards in place in order to prevent them being misused and to provide patients with safe patient-centred care. Over the course of one year we have taken swift and robust action against 36 pharmacies and a superintendent pharmacist who were found not to have these safeguards in place.

“People requesting codeine linctus can be well-rehearsed, believable or aggressive and will often exploit shift patterns, relying on poor handover or communication between shifts. We are asking pharmacy owners and professionals to remain vigilant and ensure controls are in place to prevent repeat sales or to identify trends in requests.”

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