It sounds like the beginning of a Seinfeld episode. I mean, are they good for you, or aren’t they? And why does the pharmacist always keep you waiting so long? Of course, this is entirely hypothetical. But the sentiment is real. I know this because the prescription problem is one of the most frequent problems that comes up as a pharmacist. People have a generally poor understanding of how and why some medicines are prescribed while some are readily available on the shelves. Today, I will take a traipse through the complexity of prescriptions.
There are three factors that are considered when deciding whether a medicine should be kept behind the counter.
The Risk Associated with Its Use
Modern medicine has made impressive progress from the days when leeches were a golden bullet. But it is a double edged sword because the more potent the drug, the more carefully it needs to be administered. Medicines like antimicrobials, insulin or opioids all have fairly serious health implications if you took too much in one go. So the prescription exists to make sure that a doctor or pharmacist has spoken with you so that you can take it safely. It also ensures that someone doesn’t buy excessive amounts in one hit which greatly increases your chance of risky behaviour.
How It Needs to be Delivered into Your Body
Not everything is as simple as taking a pill. Some medicines need to be delivered intravenously, and most people would feel pretty uncomfortable being asked to do this independent of any help from a doctor or pharmacist. Granted, this is a fairly extreme example. A more frequent example might be if the medicine needs to be ingested at particular times, or whether certain substances (foods or other medicines) might affect how you take this particular drug. Ultimately, it is for your own good that a health professional is there to assist you.
The Potential for Misuse
Let’s start with something like antibiotics. A lot of people go to their doctors, begging them to prescribe an antibiotic for a cold. After 2 or 3 days, they start to feel better and lo and behold, they forget to take the odd pill. Before you know it, they’ve stopped altogether. Now, this is a serious problem. Just because the symptoms of the illness are gone, that doesn’t mean you have entirely killed the virus. Finishing the script will finish the virus. But if you stop halfway through, you allow the virus to get a good look at the drug, and it starts to mutate so that the drug no longer works. They then jump ship to some other poor soul, and they have to suffer for a few weeks because nothing can shake the illness. A lot of people have been guilty of not finishing a script, and right now you’re probably thinking I’m being a bit harsh. But now imagine that you are the poor sucker who picks up an antibiotic resistant strain. It’s not so funny anymore. Secondly, if we overuse antibiotics, the virus will become more resistant over time. That is why we act as the gatekeepers. If anyone could decide that they wanted to nuke this cold into oblivion by buying a thousand packets of antibiotics, we would find ourselves severely outgunned in those rare instances when we actually need them.
Now let’s move onto the slightly more worrying instance of misuse. You might have heard in the news about the Opioid crisis that is gripping America. An opioid is a seriously powerful painkiller that numbs the pain receptors in the body. It is extraordinarily useful when you are in a world of hurt. When I had all four wisdom teeth removed in the chair, endone was a real comfort for a few days. But in America, drug companies pushed these powerful painkillers through doctors, and got people hooked. Like anything, there is the law of diminishing returns, and you end up hooked and needing more to get to the same state of comfort as before. In 2020, legal opioids were responsible for almost 50,000 deaths. That is the equivalent of a packed out SCG. You can probably imagine why these drugs need to be kept under lock and key. If you’ve just had serious surgery, you need them. If you take them because you like how they make you feel, you don’t need them. You need help. It is as genuine a drug addiction as heroin or nicotine. Just because it is ‘legal’ that doesn’t mean it isn’t lethal.
One of the big challenges in disrupting the traditional pharmacy market is how to deliver online prescriptions in a way that doesn’t overstep any of these three categories. Of course, you still need a doctor to prescribe these medicines. Online prescriptions work by establishing a patient login so that we can keep a very close eye on who is taking what. We take the prescription, enter in all the data to register that script as having been filled and deliver the medicines to you straight away. Online prescriptions are no less safe and rigorously tested as picking them up at an analogue pharmacy. They cannot be filled multiple times across multiple pharmacies because the codes on the script will now be defunct. As a pharmacist, I take the safety of my customers and my most potent medicines extremely seriously. This is actually what drove our decision to launch online prescriptions. Whether you are less mobile or simply less confident in stepping into a crowded shop, this model allows you to access the medicines you need at the click of a button.
As always, you can use our ‘ask a pharmacist’ function on the website to chat live with a pharmacist who can answer all of your questions. It is just one of the ways we are working to make the online space even more accommodating than the physical shopfront.
Floyd - Senior Pharmacist
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