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Your RPS 

RPS calls for investigation after online pharmacies prescribed opioids to undercover reporter

According to The Times, a reporter was able to buy opioids from five online pharmacies by filling in an online questionnaire and sending a photocopy of their passport.

Dihydrocodeine tablets

Source: PjrStudio / Alamy Stock Photo

The Times’s report said that one online pharmacy allowed the reporter to purchase two batches of dihydrocodeine tablets on consecutive days

The Royal Pharmaceutical Society (RPS) has called for an urgent investigation to be carried out after five online pharmacies prescribed opioids to an undercover reporter for The Times without contacting the reporter’s GP.

According to The Times, the reporter was able to buy the medicines — including 200 tablets of 30mg dihydrocodeine and 100 tablets of 30mg codeine — by filling in an online questionnaire and submitting a photograph of their passport. The reporter said that at no point did the reporter agree to their GP being contacted, and yet the medicines were still dispatched. 

The pharmacy that sold the 200 dihydrocodeine tablets also allowed the reporter to purchase a second batch the following day,  the report in The Times noted. 

Neal Patel, head of corporate communications at the RPS, said: “These findings are concerning, and I would expect a full and urgent investigation by regulators. In our view, an online consultation should meet the same standards as a face-to-face consultation.

“There are guidelines in place for pharmacies providing online pharmacy services, from the General Pharmaceutical Council (GPhC), which have been updated in April 2019.”

The updated GPhC ‘Guidance for registered pharmacies providing pharmacy services at a distance, including on the internet’ says that any patient requesting opioids should be asked for details of their GP and for consent for the pharmacy to contact that GP.

The guidance also says that when medicines are liable to be abused or misused, online pharmacies should be assured that the prescriber has contacted the patient’s GP before issuing the prescription to check that the medicine is appropriate for the patient.

In September 2019, the GPhC announced that all online pharmacies who had asked to use its voluntary internet pharmacy logo had been asked for a copy of their risk assessment of the services they provide online. The GPhC also asked them for a list of changes they have made to their online services as a result of the updated guidance. 

Patel added: “If there are circumstances where the person does not have a regular prescriber, such as a GP, or if there is no consent to share information, and the prescriber has decided to still issue a prescription, then pharmacists should assure themselves that the prescriber has made a clear record setting out their justification for prescribing.”

Although the report said that five online pharmacies provided the medicines without the GP’s approval, it did not say how many online pharmacies were included in the investigation and whether other pharmacies had refused to prescribe.

Citation: The Pharmaceutical Journal DOI: 10.1211/PJ.2019.20207125

Readers' comments (5)

  • I feel there are a group of people in society who suffer from pain that can not be helped with anything other than opioid medication. Pain clinics, alternative therapies, learning to “accept the pain”, pain tool kits etc, are not helpful to some types of pain. For example regular Pilates and acupuncture is not helpful to someone who has hyper mobility in the urethra and has to self catheterise in order to urinate whilst also having frequent urinary tract infections with thrush afterwards from antibiotics. The act of going to the toilet and having to push the catheter up the urethra resulting in unbearable pain due to the inflammation and infection, there is no choice but to take painkillers. Am sure there are many other such examples of chronic conditions, however, this group of people are becoming marginalised and placed under the same umbrella of opioid medications not being the answer, when in fact, it is the only option presently that helps. When GP’s then have to follow new guidelines and reduce or stop opioids, such people turn to other options such as ordering medication online, now that’s been cracked down on as well. Where do these people go?

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  • These new regulations only make it a pain to obtain pain medication for those who need it.

    The ones who were abusing codeine and dihydrocodeine will buy the OTC products, buy pills on the street or from dodgy online places and possibly hurt themselves with questionable pills. They are not gonna suddenly quit because you make access to these weak opioids more difficult. They are only a tiny percentage but of course sensationalistic articles only focus on the minority that abuses the stuff.
    If anything it is safer to abuse pure codeine pills than co-codamol. Codeine by itself doesn’t give you liver failure in overdose or destroy your stomach and anyway codeine is hard to overdose on since it is very weak.

    Also, asking the customer’s GP if the questionare completed online is truthful is ok but I don’t see why, if the GP confirms the questionnaire is truthful, another prescriber should have their permission to prescribe a medicine. The questionnaire is designed to ascertain if the medicine is appropriate so once that is established and verified from the GP another doctor etc. has the same ability as the GP to judge if the medicine can be prescribed. It’s not like the GP with the same info as the prescriber can judge the customer’s pain better just because they see the patient in person. All a prescriber needs to know is if the diagnosis given by the customer to need pain relief is true and if they have any condition etc that would make it unsuitable for them to be prescribed codeine or if they are known by their GP to be addicts. That’s all they need to know from a GP. Not have their “permission”. I find that ridiculous to be honest. Both figures are professionals who should be able to come to the same conclusions with the same info.

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  • Sorry about the typos. Typed this on the phone. It is “questionnaire”.

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  • Lara Croft
    I quit because I couldn't get them online anymore so don't assume others won't too

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  • I’m really not surprised people have turned to self medicating, I don’t need to go in deep explanation to justify my opinion to someone else , I have been to and fro my doctors for 2 years telling them there’s something wrong, I was turned away every time . The last trip was 9 weeks ago I was twitching, violently. And asked for a short term prescription of diazepam and was told flatly no , I left there went to Tesco good job my husband was driving, I had a violent seizure, ended up in. an ambulance, during the seizure I severely hurt my back, so 9 weeks and I still can’t have anything that helps , I’d sooner be addicted than stuck staring at the ceiling for 9 weeks. I don’t know why these exist if we are not allowed to take them, I don’t feel the nhs are educated enough to take the responsibility of my health, I took all there advice and medication and could of so easily Died had I been driving, I or probably would of crashed: where I couldn’t off n

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