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First do no harm

Selling recreational drugs over the counter may well be a step too far for pharmacists.

Leader graphic Farmacia

In December 2013 Uruguay became the first country to legalise cannabis for medical, industrial and recreational purposes. The Uruguayan government believes the move will divert income away from criminal gangs, and the taxes collected are to be invested in health, education and the prevention and treatment of drug abuse.

The situation in Uruguay is unusual in that pharmacies are being touted as one of the official outlets for the drug.

In countries such as the Netherlands and the Czech Republic patients can have cannabis dispensed by their pharmacist for medicinal use; but this cannot reasonably be likened to the plans in Uruguay. If it is accepted that drugs like tobacco and alcohol have no place within pharmacies, it would seem contrived to suggest differently for recreational cannabis.

Pharmacists expected to sell any drug for recreational use in pharmacies puts them in conflict with their professional code of ethics. The Association of Chemistry and Pharmacy of Uruguay (AQFU) opposes the move, arguing that the perception of pharmacies in society will be damaged and the role of pharmacists as healthcare providers compromised. It has started an online petition to get the law changed, a stance supported by the International Pharmaceutical Federation.

It could be argued that the sale of e-cigarettes in pharmacies — contentious in itself and not supported by the Royal Pharmaceutical Society — might be justified on the grounds that it provides an element of harm-reduction. The same goes for opiate substitution therapy and needle exchange programmes through pharmacy. This argument does not extend to marijuana.

Members of the public might be able to receive, along with their weed, advice from pharmacists about the risks of using the drug. And community pharmacies in Uruguay have a system for recording supplies and can be expected to enforce the legal quota of 40g of marijuana per month. Nevertheless, most pharmacies there do not always have a pharmacist on the premises.

Any perceived benefits of using pharmacies to supply marijuana would be outweighed by the redefinition of pharmacists’ role in society: from one of a provider of medicines and expert advice to that of a seller of recreational drugs. The Uruguayan government should heed the concerns of the country’s pharmacists and rethink this part of the new law.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2014.20065627

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