PHARMACISTS have recognised misuse of over-the-counter medicines for many years. Historical approaches to tackling this problem have centred on refusing sales or restricting quantities purchased. This has led to some medicines, where concern of misuse is high (eg, cyclizine), being effectively treated as prescription-only medicines with widespread refusal of sale. In other cases, products have been hidden from open display, with enhanced questioning of potential purchasers (eg, kaolin and morphine, and promethazine). More recently, legislation has led to restrictions in pack sizes and maximum quantities per sale (eg, opiate containing analgesics).These approaches share a common theme of restricting supply and are a seemingly natural extension of the medicines and drugs legislation in the UK and beyond. However, this approach has proved inadequate and we suggest that it is time for our profession to take a more proactive approach in supporting patients who misuse OTC products.
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