Identification Needed for Medication with Codeine

To my knowledge, pharmacies are supposed to have always recorded patient details when dispensing schedule 2 medicines, but to date haven't really bothered to do so.
 
Indeed. From the Medicines And Related Substances control Act 101 of 1965:

A prescription book or other permanent record in respect of schedules 2, 3, 4 and 5 medicines or substances shall be kept on all premises where prescriptions are dispensed or sold and shall contain the following details:
  • the name of the medicine or scheduled substance;
  • the date on which the prescription was dispensed;
  • the dosage form and quantity of the medicine or scheduled substance;
  • the name and address of the patient, or, in the case of a prescription issued by a veterinarian, the name and address of the person to whom the medicine or scheduled substance was sold;
  • where applicable the name of the medical practitioner, dentist, veterinarian or any other authorised person who issued the prescription.
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Historically most pharmacies have broken the law in the way they dispensed schedule 2 medicines.
 
copacetic said:
That is very dangerous stuff, as people get addicted to the codeine, and then take in amounts of paracetamol that can kill them.

I don't actually know if this is silly, now that I think about it - Depends on what they do with the information, and if they can in fact help people with their addiction. It's no help if the people can just go get the stuff somewhere else.
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Yeah? Enlarge some with more details. How much codeine and paracetamol together is cause for safety concern?
 
Well it is already a problem. Just with the 10mg of codeine and 400 of paracetamol.
I know some addicts who klap 30 pills a day.
4 or 5 times more than the daily dose.
 
Seriously said:
Yeah? Enlarge some with more details. How much codeine and paracetamol together is cause for safety concern?
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I would not worry about the codeine itself, as the doses in the OTC stuff are tiny on their own. Which is actually half the problem - People want more codeine and as a result take in more paracetamol, which can lead to:

http://en.wikipedia.org/wiki/Paracetamol_toxicity

Paracetamol toxicity is caused by excessive use or overdose of the analgesic drug paracetamol (called acetaminophen in North America). Mainly causing liver injury, paracetamol toxicity is one of the most common causes of poisoning worldwide. In the United States and the United Kingdom it is the most common cause of acute liver failure.[1][2]
Many individuals with paracetamol toxicity may have no symptoms at all in the first 24 hours following overdose. Others may initially have nonspecific complaints such as vague abdominal pain and nausea. With progressive disease, signs of liver failure may develop; these include low blood sugar, low blood pH, easy bleeding, and hepatic encephalopathy. Some will spontaneously resolve, although untreated cases may result in death.
Damage to the liver, or hepatotoxicity, results not from paracetamol itself, but from one of its metabolites, N-acetyl-p-benzoquinoneimine (NAPQI)(also known as N-acetylimidoquinone).[3] NAPQI depletes the liver's natural antioxidant glutathione and directly damages cells in the liver, leading to liver failure.[3] Risk factors for toxicity include excessive chronic alcohol intake, fasting or anorexia nervosa, and the use of certain drugs such as isoniazid.
Treatment is aimed at removing the paracetamol from the body and replacing glutathione. Activated charcoal can be used to decrease absorption of paracetamol if the patient presents for treatment soon after the overdose; the antidote acetylcysteine acts as a precursor for glutathione, helping the body regenerate enough to prevent damage to the liver.[3] N-acetylcysteine can neutralize NAPQI by itself as well.[3] A liver transplant is often required if damage to the liver becomes severe. Patients treated early have a good prognosis, whereas patients that develop major liver abnormalities typically have a poor outcome. Efforts to prevent paracetamol overdose include limiting individual sales of the drug and combining paracetamol with methionine, which is converted into glutathione in the liver.
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Generally, the maximum daily dose is 4 grams, and toxicity can start at around 10. This is not a big gap, especially for people who are unaware that it could be dangerous. From what I've seen, you generally get around 0.5 grams per the typical pills, of which most people take two. So someone looking for a buzz could easily exceed the 20 pills in a 24 hour period.
 
copacetic said:
That is very dangerous stuff, as people get addicted to the codeine, and then take in amounts of paracetamol that can kill them.

I don't actually know if this is silly, now that I think about it - Depends on what they do with the information, and if they can in fact help people with their addiction. It's no help if the people can just go get the stuff somewhere else.
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i think if you have an addictive nature then you would become addicted to anything. i was on stilpain for 6 months for this pain in my shoulder until i told my gp to send me to someone to sort it out. i couldn't take the pain anymore. i was taking up to 10 a day the pain was getting so bad. since the op i haven't taken any. now considering that i had taken the stuff for so long and the amount that i had been taking, i think that i should have become addicted to it don't you? yet i haven't. the minute i had the op and the only pain i had was the "after op pain" i stopped taking it immediately. i didn't wean off it either, there was no need to as far as i was concerned.
 
All that Grandpa is is Paracetamol and Aspirin with a bit of caffeine for good measure. To call it poison is misguided, to recognize that its ministrations are potentially harmful is a different story. Take a Disprin and Panado and you have the same thing.

Pharmaceutical drug addition is prevalent among people with addictive personalities etc ... but should we be particularly concerned - surely absent harm to others if somebody wants to use pharmaceutical products in a particular way to the detriment of their own health is their own decisions.
Information and informed consent is what is key. If somebody is in pain they will take whatever the medical professionals minister to them without considering the risks to their health and for those purposes guidelines and heavy regulation seems sensible but to try and extend that system to stop people from choosing to use certain substances is just daft.

Now this particular industry imposed measure arises precisely because of the co-substance harm problem - people become addicted to a particular OTC formulation which has codeine (low dosage) and paracetamol or aspirin or ibuprofen. Because the formulation meets the lower scheduling criteria - and to keep costs down - a particular risk exists. By requiring the presentation of an ID - and there isn't a suggestion of records beyond the existing register - is a good way to make it just that little bit more clear that the stuff is addictive etc ...
 
http://www.iol.co.za/news/south-africa/over-the-counter-drugs-abuse-rife-1.363212#.UlGfhoZmh8E

Another common over-the-counter addiction is to antihistamines like Syndol, used to induce sleep, and Grandpa headache powders, typically swallowed with Coke.

Grandpa contains a combination of paracetamol, aspirin (both painkillers) and caffeine, which, loaded with extra caffeine from Coke gives the user a mildly euphoric feeling and a "lift".

"Dependency on Grandpa is very dangerous," says Ane Carelson, social worker and marketing manager for Elim Clinic, a drug rehabilitation centre in Kempton Park.

"An overdose of paracetamol causes a lot of damage to the liver and kidneys. You can develop ulcers.

"Some people are taking 10, maybe 15 a day, which can be lethal."
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copacetic said:
No.

You seem to under the impression I am saying that anyone who takes these pills will become addicted.

Which I did not.
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no copa, i was saying that i had taken the tablets for so long that i perhaps should have become addicted to them. isn't that what normally happens? i don't know, i just think i don't have that addictive nature that's all.
 
I don't think this is about personal usage as much as it is dealers buying the stuff to water down into other rubbish.

So now one person can't run to 10 different shops and buy the maximum available without a pattern emerging.
 
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