World news wrapup: 25 January 2018

Chicago's South Side.
Chicago's South Side.

NZ body slams codeine upschedule; UK pharmacists helped to spot radicalisation; Chicago plagued by ‘pharmacy deserts’

Lincolnshire, UK: A pharmacy in Sleaford is the first in the UK to provide a needle exchange program through a vending machine, Chemist + Druggist reports.

Riverside Pharmacy decided to implement the service after Addaction, a drug, alcohol and mental health charity, approached it about funding and installing the machine. Addaction then assisted Chris Mulimba, the pharmacy’s superintendent pharmacist, to acquire it.

Patients can now place used needles in a bin and get a new one from the vending machine after a pharmacy staff member gives them a plastic token.

The machine halves the time it takes staff to perform a needle exchange, Mr Mulimba told C+D.

“A traditional method takes 10 minutes – you have to assemble the indvidual [pack],” Mr Mulimba says. “The [vending machine] has everything pre-packed; the only time it takes is talking to the client about harm reduction.

“My pharmacy has a small, very busy counter. Introducing a full-scale needle exchange service wasn’t going to be feasible, because staff would be put under a lot of pressure.”

Because the machine is located in a consulting room, the service also offers improved privacy and better communication between patient and staff, he says.


UK: Britain’s National Pharmacy Association has produced guidance for pharmacists on how to spot radicalisation and help prevent terrorism, the Pharmaceutical Journal reports.

The NPS suggests pharmacists should check their staff’s use of pharmacy computers to find out whether they are watching violent or extremist material, and be “vigilant” when it comes to any new contacts a staff member or patient may have made.

They are also encouraged to listen out for staff or patients who “express new views that seem out of character and related to extremism and terrorism”.

The guidance follows two recent cases where pharmacists were involved in terrorist activity. One pharmacist was found guilty of preparing terrorist acts, while another was found guilty of disseminating terrorist materials and sentenced to six years’ imprisonment.

The guidance also covers inappropriate sexual behaviour.


New Zealand: New Zealand’s answer to ASMI, the New Zealand Self-Medication Industry, has slammed the recent decision to make OTC codeine combination analgesics and cough treatments prescription-only.

The change will take place from January 2020 – but single ingredient codeine medicines will be downscheduled from prescription only to “restricted,” and become available in small packs from a pharmacist following consultation and recording.

“We are disappointed that the MCC did not take the opportunity to encourage better recording of sales OTC and instead has pushed all codeine-in-combination products to prescription-only where anecdotal evidence and earlier research suggests the bulk of abused codeine is procured,” says SMI executive director, Scott Milne.

Mr Milne says the decision means a valuable opportunity to develop a real-time recording system for codeine purchases proposed by SMI and the Pharmacy Guild may have been lost.

“Pharmacists here are required by law to determine whether it is appropriate to supply over-the-counter painkillers containing codeine and a move to prescription-only disregards the expertise of pharmacists and their important role in the frontline of primary care.

“The current scheduling of these medicines means consumers must seek counselling from a pharmacist during the purchase of codeine-containing products and the purchase must be recorded.

“However, this is currently not done in real time. A real time recording system would severely inhibit the opportunity for opiate abusers to shop around for codeine-containing product.

“Pharmacists have the professional expertise to address any questions consumers may have about these products,” he says.


Chicago, Illinois: The Chicago Tribune has published an investigation into the growing problem of “pharmacy deserts” in predominantly poor neighbourhoods with a significant black and Latino demographic.

Dima Qato, an assistant professor in the department of pharmacy systems, outcomes and policy at the University of Illinois, is involved in a three-year program aimed at researching and solving the pharmacy desert problem.

“A lot of public attention focuses on insurance, but that’s not enough,” said A/Prof Qato.

“Even if medications are affordable, if the pharmacy isn’t accessible, they’re not accessible.”

Of particular concern is lack of access to naloxone, given the incidence of opioid overdose on Chicago’s South and West sides, the areas most affected by pharmacy deserts.

Tribune reporters Ese Olumhense and Nausheen Husain spoke to 77-year-old Emma Washington, whose neighbourhood pharmacy closed and who now needs to take two buses to get to the next closest to get medicines to treat her high blood pressure, kidney condition and diabetes.

“Am I supposed to travel in [ice and snow] or wait until my daughter has a day off — if she has a day off — to get my medicine?” she asked.

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