I’ve been a community pharmacist for 35 years but the last four months have been the most intense, stressful and uplifting of my life. One highlight was meeting a former EastEnders actor, says Shaheen Bhatia...
 

It was a long day at P&S Chemist in June and I got quite excited at the sight of a crowd building up, with social distancing having gone out the window. They jostled for a better view but they were not there to see me. They were there to see Ross Kemp.

I had been asked to take part in his documentary called ‘Ross Kemp: Living with Painkiller Addiction’ on June 25 about the misuse of OTC and prescription opiate medication.

The programme highlighted the UK is on the precipice of an opiate crisis, with opioid deaths rising by 50 per cent in the last five years.  Although OTC painkillers have had addiction-warning labels since 2009, it was only last year health secretary Matt Hancock requested all POMs have warning labels.

This concern was raised after a report that prescriptions for opiates increased by 60 per cent in the last 10 years.

Ross asked me to display all the OTC painkillers that had an opiate. The list was longer than I’d thought and naturally the POM products list was even greater. Ross had a keen interest in Fentanyl, the strongest opiate in potency.

The documentary revealed severe addiction problems in people, ranging from OTC Co-Codamol to the use of heroin. The plight of people using street heroin was starkly exposed. This group are at most risk of an overdose from opiates particularly when, unknowingly, unsavoury dealers lace heroin with fentanyl to ‘bulk it up.’

Sadly, my chat with Ross about how all pharmacies have guidelines and protocols in place that are used to advise on the sale of addictive medicines and how pharmacists will always intervene to offer support and signpost where to get help was omitted from the documentary.

Having said that, I realised I too needed to refresh my staff on this subject.

Another omission was that selected pharmacies across the UK are giving out Naloxone injections (opiate blocker) to all clients who use the NHS needle exchange programme and to our methadone clients as well.

If you wish to access these then do ask your local drug and alcohol clinic if they are providing them, or better still, ask them to commission you.

Once the programme was aired, it was obvious we needed team training to ensure good protocols are followed for OTC products. For opiate POMs, interventions are made to caution patients on the addictive nature of these medicines.

I recall a young woman who suffered a minor elbow injury was prescribed Co-Codamol at A&E, yet months later it was still being prescribed. How many times have we seen Co-Codamol and Tramadol being a repeat-prescription item unnecessarily?

Throughout the Covid-19 pandemic deliveries increased exponentially, resulting in reduced patient contact time. The opportunity to discuss the cautious use and side effects of these medicines diminished.

There’s no doubt the problem of being able to provide this advice adequately got worse. Perhaps the opiate group of drugs should be added to the New Medicine Service.

Can we ask PSNC that we have a service dedicated to addressing this issue, looking to Scotland’s example of using remote consultations?

Meanwhile, for those wishing to refresh themselves on this subject or for team training, I recommend the Centre for Pharmacy Postgraduate Education’s programme Addiction, Misuse and Dependency. It’s excellent.

I didn’t think I would learn something from an ex-soap celebrity-turned-documentary filmmaker but I certainly did.

The documentary and the power of the media proves the message is out, so don’t be surprised if you get asked about opiates.

Shaheen Bhatia is a community pharmacist based in east London.