pharmacy drugs- These are drugs with a powerful analgesic or sedative effect, which are highly addictive and are not used for their intended purpose. Drugs with narcotic substances in the composition are available in every pharmacy, and many of them are available without a prescription. Pharmacy addicts most often become "addicted" to prescribed drugs, patients who have already taken place opium addicts and just curious young people.
Legal drug dealer
While the state is fighting the distribution of conventional drugs, pharmacies are becoming legal drug dealers. Officially, all medicines with narcotic compounds are divided into 3 control groups:
- Preparations 1st group available only after a mandatory call to the medical facility and verification of the authenticity of the prescription.
- Preparations 2nd group issued only on prescription, but without additional checks.
- Preparations 3rd group issued without a prescription.
This is how the system should work. But in fact, many pharmacies violate control rules and dispense psychotropic drugs without the necessary permission. There is only one reason - drug addiction brings a lot of profit to the pharmacy business. For the possibility of legal purchase of the drug, addicts are ready to pay an inflated price, and thanks to the availability of these drugs, the number of pharmacy drug addicts is only growing.
List of pharmacy drugs - 2018
Lyrics
It is a medicine for epileptics that relieves seizures. In the past, it was used by narcologists to combat withdrawal symptoms - brittleness.
In its action, Lyrica is similar to morphine, heroin or methadone. It also forms a strong addiction and immerses in a state of euphoria, which drug addicts prolong by drinking alcohol with pills.
Signs of dependence on Lyrica:
- Nervous, aggressive behavior.
- Mood swings - from hysterical fun to tears.
- Unsteady gait, impaired coordination.
- Dilated pupils.
- Increased sweating.
- Skin rash.
Consequences of abusing Lyrica:
- Chronic fatigue syndrome: drowsiness and feeling of weakness, confused consciousness.
- Apathy and thoughts of suicide.
- Impotence in men, hormonal disruptions in women.
- Migraines and memory impairment, fainting.
- Cramps, muscle pain.
- Tremor.
- Confused speech.
An overdose of Lyrica results in coma and death.
Terpinkod, Nurofen plus
This popular cough remedy clears phlegm from the respiratory tract. Terpinkod contains the psychostimulant codeine. To achieve euphoria, addicts drink 2-5 packs at once, or extract crude codeine from pills and inject it intravenously.
A cheap analogue of Terpinkod - Nurofen plus, practically does not differ in psychotropic effects. Addiction occurs after 3 packs.
Signs of dependence on Terpinkoda:
- Earthy or gray skin, peeling skin.
- Freezing in one position, motionless gaze.
- Red eyes.
- Strong weight loss.
Consequences of abuse of Terpinkod:
- Poor eyesight.
- development of heart disease.
- Migraine.
- Rotting skin.
- epileptic seizures.
- Death of brain cells, dementia.
- The development of mental disorders and suicidal tendencies.
In terms of destructive power, Terpinkod is superior to cocaine. A fatal outcome is possible after a few months of admission - a person dies from a sudden stoppage of breathing.
Tropicamide
Tropicamide - eye drops. Ophthalmologists use it in the study of the fundus and prescribe it for inflammation.
In large doses, Tropicamide plunges into a state of euphoria, provokes auditory and visual hallucinations.
Drug addicts inject it through the veins and muscles, drink it as a solution, mix it with opiates. Persistent addiction to Tropicamide develops in just a month.
Signs of dependence on Trapicamide:
- Dilated pupils.
- Increased sensitivity of the eyes to light.
- Yellowish skin tone.
- Scattered attention.
- Decreased memory.
Consequences of abuse of Trapicamide:
- Serious visual impairment. Problems with focus and clarity, pain in the eyes from sunlight, partial and complete blindness.
- Cardiovascular diseases. Arrhythmia, the development of deadly infective endocarditis. The appearance of blood clots after intravenous injections.
- Problems of the nervous system. Cramps, burning in the muscles.
- Mental disorders. Psychosis, panic attacks, schizophrenia, depression, suicide.
- Diseases of the liver and kidneys. Hepatitis and cirrhosis of the liver, acute renal failure, urinary incontinence.
- Purulent inflammation. Abscesses-abscesses appear at the injection sites, which spread infections throughout the body.
Exceeding the dose leads to paralysis of the respiratory center of the brain, coma and death.
Tramadol
This is a powerful analgesic, it is prescribed for severe pain in case of injuries and serious illnesses, or to reduce pain during diagnosis.
Drug addicts take pills in increased doses, or make solutions for intramuscular and intravenous injections. The drug gives a surge of vivacity, a feeling of looseness, a desire to sympathize and help people. However, the peaceful mood is quickly replaced by aggression and apathy when the effect of Tramadol weakens. Already after 2-3 doses of the drug there is a strong attachment.
Tramadol addiction symptoms:
- Pale skin with red patches.
- Red eyes.
- Constant thirst.
- Dizziness, difficulty with orientation in space.
- Rapid transitions from apathy to excitement.
- Decreased performance.
- Drowsiness or insomnia.
Consequences of tramadol abuse:
- Head and muscle pains, aching joints.
- Tremor, epilepsy.
- Arrhythmia, tachycardia, acute heart failure.
- Cirrhosis of the liver.
- Nausea, vomiting, loss of appetite, pain in the abdomen.
- Dementia.
- Panic attacks.
- Psychosis, aggressive antisocial behavior.
- Hysteria.
- Depression, suicidal tendencies.
Tramadol quickly wears out all body systems. A drug addict who is addicted to it lives no more than 3-4 years. With an overdose, blood pressure drops sharply, suffocation, pulmonary edema and sudden respiratory arrest occur.
Coaxil, Prozac, Zoloft, Aurorex
These are powerful antidepressants with almost identical effects on the psyche. Drug addicts use them to save themselves from withdrawal, and as a result they get addicted to a new drug.
An increase in dosage gives a pronounced sedative effect: a person relaxes, feels joy and carelessness, loses a sense of reality.
Signs of addiction to antidepressants:
- Mood swings, inappropriate behavior. The addict is often overexcited, laughing or crying for no apparent reason.
- Nervousness and aggressiveness. Without a new dose, the addict feels deeply unhappy, becomes nervous and suspicious, breaks down on others.
- Feeling unwell. Fainting, dizziness and nausea become more frequent.
Consequences of abuse of antidepressants:
- Acute psychosis, uncontrollable rage.
- Severe depression.
- Tachycardia and arrhythmia, heart failure.
- Chronic fatigue and insomnia.
- Thrombus formation.
- Stomach ulcers, gastritis, diarrhea and constipation.
- Epilepsy attacks.
An overdose of antidepressants results in sudden cardiac arrest or lethargy with a fatal outcome.
Treatment of drug addiction
The Decision Rehabilitation Center for Drug Addicts offers effective treatment for drug addiction. The rehabilitation program includes:
- intervention.
Most often, the addict denies his problem and refuses the help of doctors. In this case, our psychologists come to the patient at home and, together with relatives, gently convince him to start rehabilitation.01 - Detoxification.
To eliminate the effects of withdrawal, we cleanse the body of toxins with the help of special medicines and a balanced diet. Detoxification is the first step to recovery that gets rid of physical addiction.02 - Hospital treatment.
During rehabilitation, the patient lives on the territory of a comfortable country hospital. He is temporarily isolated from society and completely focused on the course of treatment. Residents of the hospital learn the details of their illness, attend group and individual psychotherapy sessions. They learn to analyze and control their emotions, build healthy relationships with others and deal with stressful situations without drugs. Psychologists help patients find healthy life values, regain self-respect and the trust of loved ones.03 - Ambulatory treatment.
At this stage, the patient lives outside the center and regularly attends classes with a psychologist. Specialists help him adapt to a sober life in society, improve relationships with family and friends. We control the state of the former drug addict, so we can prevent a breakdown in time.04 - Return to full life.
Throughout the program, residents receive valuable professional and social skills, and at the end of the course, we can employ them in our center. Our specialists also prepare graduates for interviews if they want to grow and develop elsewhere.05
Pharmacy addiction more dangerous than any other, because medicines are always in the public domain within walking distance of your home. The risk of relapse in drug addicts is high. Therefore, in the event of a breakdown, our clients can undergo a second course of treatment free of charge.
And most importantly, all our patients and their relatives receive a lifelong right to support our drug treatment clinic: they can contact us at any time for help and advice.
For medicine - only with a prescription. From January 1, control over pharmacies that dispense medications without a doctor's prescription will be tightened. How this will affect patients and whether it will be possible to buy pills for headaches or colds in the new year without waiting in line at the clinic, the correspondents of DDD found out.
It's not the law that changes, it's the enforcement
“If we talk about the rules for dispensing drugs by pharmacies, nothing will change,” explains Olga Novikova, chairman of the health committee of the Kursk region. - In 2012, the Ministry of Health approved the procedure for prescribing and prescribing medicines and the form of prescription forms. If the instructions for the drug contain the line “prescription only”, the pharmacist must make sure that there is a prescription from a doctor. Another issue is that pharmacies often ignore this requirement. Innovations will affect the expansion of the powers of Roszdravnadzor, which monitors compliance with these rules.”
Today, the department can only carry out scheduled inspections. As practice has shown, their effectiveness is minimal. Pharmacies both sold medicines without a prescription and still sell them. Experts believe that allowing the use of the method of control purchases of medicines will help turn the tide. Not knowing exactly when the test will come, pharmacists will be more careful.
In addition, from January 1, 2017, fines for this violation should increase. If the fact of selling a medicine without a prescription is revealed, Roszdravnadzor can fine the pharmacist who violated the law in the amount of 5 to 10 thousand rubles (now - from 1500 to 3000 rubles); the official will have to pay from 20 to 30 thousand (now - from 5 to 10 thousand); legal - from 100 to 150 thousand rubles (now - from 20 to 30 thousand rubles). The most serious punishment could be the closure of a pharmacy for three months.
The fight against self-medication
Why all these difficulties? First of all, experts expect that in this way it will be possible to wean patients from the bad habit of self-treatment. “How do people most often choose their medicines? They do not go to the doctor, but look for information on the Internet, ask friends or ask a pharmacist at a pharmacy: “What should I buy from so-and-so?” Yes, the pharmacist knows a lot about drugs, but he knows nothing about the person himself and about the characteristics of his body! Olga Novikova complains.
Sad examples of the negative consequences of such an approach are enough. So, babies periodically get into the intensive care unit of the regional children's clinical hospital with poisoning from drops from the common cold. “Using vasoconstrictor drugs, parents forget that there are drops for adults and children,” explains Svetlana Guseva, deputy head physician for medical work. “But even with the use of a children's remedy, a child can get an overdose.”
If the dose is exceeded, the drug enters the bloodstream and causes a narrowing of all the vessels of the body, which leads to oxygen starvation of the brain. Drowsiness, lethargy and lethargy are the first alarming symptoms. When the drug continues to accumulate in the body, slowing of the heart rate and even coma is possible.
Another serious problem, according to Svetlana Petrovna, is the prolonged and uncontrolled use of antibiotics. After such self-treatment, patients increase resistance - the body's resistance to the active substance of the drug. And in a really difficult situation, the antibiotic is ineffective.
Dangerous antibiotics
Tighter controls on the sale of antibiotics, and even a ban on the introduction of these drugs outside the walls of medical institutions, were discussed after high-profile deaths as a result of the introduction of antibiotics. Within two months, two children died in Kursk. A 6-year-old boy died on September 10, the local pediatrician prescribed him the drug, and his mother gave the injection. On October 31, a 10-year-old schoolgirl died. In this case, the parents did not go to the doctor, but decided on the treatment themselves. The antibiotic was introduced by the grandmother, literally immediately the girl became ill - vomiting began, she began to choke and died a few minutes later. According to preliminary data, both children died from anaphylactic shock. It is known that children were injected with the same antibiotic, but from different manufacturers. As explained by "DDD" in the investigative committee, the examination has not yet been completed.
70% of drugs registered in the Russian Federation must be dispensed by prescription. “First of all, we are talking about antibiotics,” says Olga Novikova. - These medications should only be taken under medical supervision. We cannot prevent people from self-medicating. But we hope that new forms of control will reduce the number of such cases. Now the work is going in two directions: with pharmacies and medical institutions. It's no secret that doctors "forgot how" to write prescriptions. The names of drugs are written on leaflets, recommendations are given orally. This topic is seriously discussed with doctors: if the medicine is prescribed, the patient should not leave without a prescription. Each polyclinic has already reported that prescription forms have been purchased in the required volume.”
All showcases - without a prescription
The medal also has a reverse side. Is it really now that before going to the pharmacy you will have to go on a “crusade” to the clinic and sit in line there, most likely not an hour or two? “The system is being finalized now,” explains Olga Vladimirovna. - Of course, no one wants endless queues at clinics. Therefore, we are trying to improve the whole scheme: which room to approach the patient, and so on.”
A prescription written on a standard form should contain the name of the drug, doses and method of administration. It is valid for two months. “Such prescriptions have not been seen for several years,” pharmacists from one of the Kursk pharmacies admitted to DDD. - The sale of codeine-containing drugs is strictly controlled. But doctors write the names of painkillers, anti-inflammatory and even antibiotics on some scraps of paper. But recently the situation has changed. In December, several dozen customers came with recipes. Apparently, the doctors began to remember what it is, and “train” in their discharge on the eve of the New Year.”
But what to do if in the middle of the working day you have a headache or feel the first signs of a cold? It is unlikely that in such a situation someone will immediately run to the doctor. “Appointment from a specialist is required only for those drugs, the instructions for which indicate “is dispensed by prescription,” explains Olga Novikova. “About 30 percent of medicines will still remain freely available.”
Firstly, these are all the medicines on display in the pharmacy window. “Of course, if the layout was done by a competent pharmacist,” the employees of one of the pharmacy chains specify. Interested in specific titles? Corvalol, citramon, nurofen (if it is without codeine), paracetamol, kagocel - all this is available without a prescription. We expect sales to decline from January. But what to do? We will follow the rules."
Representatives of Roszdravnadzor are more accurate than others in assessing innovations. “The introduction of amendments is only being discussed, so it’s too early to talk about the consequences,” says Natalya Demyokhina, head of the territorial agency of Roszdravnadzor for the Kursk region.
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I already encountered this idiocy yesterday - they refused to issue medicines without a prescription for pressure and gout, which the attending physician recommended to my husband with a note - to take constantly. Now he has to go for a prescription for the rest of his life to buy these medicines? Let the one who invented this walk around our clinics and tell us all what it's like!
Some kind of another experiment. Half of the pharmacies will close. From the doctor, you will only take a prescription that is profitable for the pharmacy with the cat it is along. Or give it to the paw. The doctor. Many will switch to herbs. they know .. they wouldn’t talk about self-treatment. when, indeed, our doctors were responsible for curing them.
Regarding antibiotics, and here are pharmacies, if they were prescribed by a doctor and did not prescribe antihistamines, and injections are required to be done by a medical worker, they are taught for this, and not by mothers and grandmothers. As for vasoconstrictors in the nose, parents will drip without a doctor and without a pharmacy , what is at home, and in any case, the pharmacy would have asked the age and given the required dosage.
People, how long will we endure everything?
This is a nightmare, and if my head hurts, I will have to drink analgin and what to do well, that in Moscow I can ask my mother's friend, and then what a madhouse is shorter
Samvel Grigoryan on the importance of attention to “insignificant” pharmacy issues
Samvel Grigoryan
Moscow city
Graduated with honors from the Pharmaceutical Faculty of the Moscow Medical Academy (now the First Moscow State Medical University) named after I.I. I. M. Sechenov. More than ten years of experience in the industry media.
Discussing important industry topics - about the list of Vital and Essential Drugs, checks, the impact of unstable currency markets on drug prices, import substitution, etc. - we sometimes forget about the “trifles of pharmacy life”, which are often no less important for the head clerk or the head of the pharmacy than called "big" problems. For example, does the pharmacy organization have the right to sell packages? Under what conditions can she employ students of pharmaceutical universities? How to help the first-timer protect himself during the epidemic? In fact, these questions are not so trifles.
"Front-line soldier" - pervostolnik
Almost every cold season, in January-February, information feeds are full of messages about the flu epidemic. Last winter, its especially dangerous "pork" strain was distributed. Pharmacies lacked protective masks, and the supply of various preventive, antiviral, hygienic, anti-inflammatory and antipyretic drugs increased significantly. During such periods, pharmacy halls are filled not only with healthy people in a hurry to take precautions, but also with people who are already sick, coughing and sneezing.
It is easy to get infected from visitors, especially if the first-timer has not been vaccinated against the flu (the reasons may be different, including contraindications to vaccination). And working at the first table increases the chances of getting infected.
Every day, several dozen sick people can come to the pharmacy table / window. They often lean towards the window, trying to pronounce the phrase louder so that the pharmacist can hear. Many have a habit of lingering at the first table/window for a long time to discuss in detail not only the issues of treatment, but life in general. Also, visitors often give prescriptions or papers on which the names of medicines are written to the primate, these items can be infected and infect the primate, especially if after receiving each visitor, as doctors do, he does not go to wash his hands (which is not provided for by any sanitary instructions and , probably impossible).
A familiar pharmacist told the following story. One of the pharmacy visitors, very respectable in age, and in appearance a lady who could not herself name the medicines she needed, at the height of the flu epidemic, tried to pass her mobile phone to the pharmacist through the window so that she could hear these names from the person on the other end of the connection. The reasons why the lady herself could not provide the names of the required medicines could well be valid. However, the method of communication proposed by her is, of course, not included in the duties of pharmacists and pharmacists. A mobile phone, due to the obvious features of its use, can certainly be attributed to items related to personal hygiene.
Of course, any pervostolnik is obliged to listen and advise the visitor on medicinal issues. But he would be unprofessional if he agreed to speak on the mobile phone of every visitor who offered it to him. I think the inadmissibility of such actions - both in the midst of the epidemic and in other seasons - is so obvious that it does not require further explanation. Therefore, such requests from visitors should be politely declined, motivating them (if motivation is needed at all) with sanitary and hygienic reasons.
To not pay twice
Pharmacists and pharmacists are daily at risk, at the forefront of the fight against the "epidemic front". The risk of contracting a viral infection in the first-timer is much higher than in representatives of most other specialties. It's one thing to work in an office where almost no one comes or a limited number of clients and partners come; and another thing - in a pharmacy, where people with flu go for medicines.
It is important to emphasize that, unlike other categories of citizens, pharmacists and pharmacists are exposed to this increased risk in the performance of their duties due to work for the pharmacy organization and the healthcare system. Therefore, it is logical that this organization and system should take care to protect its “front-line soldiers”.
Do you remember the milk that was given to workers in hazardous industries, including prescription and production departments of pharmacies? This norm in one form or another has existed in domestic legislation since 1922. Part 10 of Appendix 1 of the order of the Ministry of Health and Social Development dated February 16, 2009 No. 45n made it possible to replace the issuance of milk and other products due to such workers with compensation payments (if there is a written application from the employee).
So, in the spirit of this legal norm, why would all pharmacy organizations of the country - "both municipal, state and private" - without any orders take for a voluntary ethical norm at least a little compensation for the "front-line" epidemiological conditions. So that pharmacy pharmacists and pharmacists can, without cutting their own budget, create a stock of preventive and therapeutic agents against seasonal respiratory infections.
It may be objected to me that some pharmacy organizations make such compensation payments, and some industry enterprises have voluntary medical insurance programs (VHI). But these are precisely “separate” and “some”, but by no means all, but rather a minority. I think even the most modest amount (the degree of its modesty depends on the capabilities of the organization) allocated to the employee for protective masks, sprays and ointments to protect the nasal mucosa, disposable handkerchiefs, nasal drops, drugs for sore throats, antipyretic and anti-inflammatory, antiviral agents , perhaps also vitamins, etc., would not only be a positive act of social responsibility of the pharmacy organization, but also a prudent economic measure that would bring benefits in the form of a reduction in "absenteeism" due to illness.
The more protected the employee, the less and less often he gets sick, absent from work. The heads of pharmacy organizations know how difficult it is to find a replacement for a first-timer who has gone on sick leave, especially in the dead of winter, when several employees can fall ill at the same time. This leads to a loss of revenue, turns into a threat of violation of the routine pharmacy order, which in the event of a sudden check, which may well come to the pharmacy on peak days, is also fraught with thousands of punitive losses.
What to pack? What can be sold in a pharmacy other than drugs
Another "trifle" of pharmacy life is the topic of packaging. Not the primary or secondary packaging of the medicinal product, but the packaging of a pharmacy purchase. More than half of pharmacy buyers purchase two or more items of goods, and many of them are not in the singular.
Thus, a pharmacy purchase is often very voluminous, and if syrups, potions, solutions, mineral waters, some medical products, etc., are purchased, it is also heavy. In a word, an elementary service requires the presence in the pharmacy of bags of different sizes and strengths for packaging.
It would seem that the question is from the category of trifling. In super- and hypermarkets, ordinary grocery stores, consumers are accustomed to buying bags - more often plastic, less often paper. The legislation does not restrict grocery retailers in the right to sell them.
However, in pharmaceutical retail, everything is exactly the opposite. This topic is regulated by paragraph 7 of Article 55 of the Federal Law of April 12, 2010 No. 61‑ФЗ “On the Circulation of Medicines”. According to this paragraph, pharmacy organizations and individual entrepreneurs licensed for pharmaceutical activities, along with medicines, have the right to purchase and sell the following categories of goods:
- medical products;
- disinfectants;
- items and means of personal hygiene;
- utensils for medical purposes;
- items and means intended for the care of the sick, newborns and children under the age of three years;
- spectacle optics and care products;
- mineral waters;
- products of medical, children's and dietary food;
- biologically active additives;
- perfumery and cosmetics;
- medical and health education publications designed to promote a healthy lifestyle.
Package offer - is it possible to sell packages in a pharmacy?
Everything that does not fall under these categories of goods - including packaging bags - is not allowed to be sold in pharmacies and drugstores. Of course, the primates are not forbidden to let them go free of charge. However, not every pharmacy organization, based on its economic indicators, can afford such a gesture. After all, even if the giants of food retail, which have huge turnover, do not give away, but sell packaging, then it would be even more expensive for much more modest pharmaceutical retail enterprises.
Actually, the pharmacy organization has little choice: either to completely abandon plastic (not to mention more expensive paper) bags for packaging, or to decide on additional service losses. This begs the question: why is there such inequality, why is pharmaceutical retail worse than grocery retail, why are super- and hypermarkets allowed to sell packages, but pharmacies are not?
It is unlikely that such a situation has developed intentionally. Perhaps, when they compiled a list of goods allowed for sale in pharmacy organizations, they simply forgot about the “package issue” as “insignificant”. But after all, if you wish, you can amend paragraph 7 of Art. 55 of the Law "On the Circulation of Medicines" and correct the inequality in this matter.
Student and pharmacy
The possibility of working in a pharmacy for students is also not one of the least significant issues. For pharmacy organizations, this is an additional potential of the “labor force”, if not experienced, but young and promising. For students, this is an invaluable practical experience that cannot be obtained “at a desk”.
The Ministry of Health of the Russian Federation has developed and submitted for public discussion a new procedure for the admission of persons who have not completed educational programs of higher pharmaceutical education to work as paramedical staff. The summary of this draft order is as follows:
The right to work in a pharmacy arises for a student after completing four courses of higher education in the specialty "Pharmacy";
A certificate of study / period of study is required;
The student must also successfully pass the exam for admission to pharmaceutical activities in the positions of middle pharmaceutical staff.
I think it's obvious that the third point is the most important one. According to one of the points of the order, commissions for taking the exam should be created at the educational institutions themselves, that is, probably at the same university where the student is studying. The commission, in addition to teachers, will also include representatives of territorial bodies that carry out functions in the field of healthcare. The exam will consist of an interview, a test control of knowledge and an assessment of practical skills.
In words, everything looks very dignified, but in reality it all depends on how “bureaucratic” or, conversely, how optimal the above procedure will be. An exam, a test, exactingness is one thing, but “thorns” are quite another. I would like to see more young people in the profession. And it's certainly not a trifle!
These are the data of surveys conducted in 2016-2017 by the League of Patient Defenders.
About beautiful slogans and ugly prices
What projects have been invented to increase the availability of medicines! For example, remote leave - the law on it is about to come into force. True, AAU Soyuzpharma asks the government to lift the ban on the delivery of prescription drugs! Not delivering a prescription medicine to a sick person means to cross out the main idea that the online pharmaceutical circulation was supposed to implement. Patients with severe chronic diseases, young mothers with babies, lonely old people - they all need, as a rule, prescription drugs. And while no one is going to allow remote dispensing of prescription drugs ...
In addition, as noted on October 4 at the IX Pharmacy Summit Evgeny Nifantiev, head of the Neo-Pharm pharmacy chain: “Remote sales of drugs will not make drugs more affordable. The average check in a pharmacy network of a social orientation is 600 rubles, and the margin is 10%. That is, the average mark-up of a pharmacy for one check will be 60 rubles, this mark-up includes acceptance, storage and delivery to the buyer. And with distance selling, only the cost of courier delivery will deliver 150 rubles. - and this, please take into account, will be delivery not by a specialist with pharmaceutical education, but by an ordinary courier. So talking about the fact that prices will decrease during distance selling is just beautiful slogans to convince government representatives to allow the delivery of medicines.”
Medicines = products?
Another new idea to make pharmaceuticals “closer and more accessible” is actually a well-forgotten old one. No sooner had the "crisis-2009" passed, than at the government level they started talking seriously about selling medicines in stores. Eight years ago, the proposal was supported by the FAS and the Ministry of Industry and Trade - but the Ministry of Health and Social Development blocked the amendments prepared by the federal ministry in charge of pharmaceutical production.
In 2012, the Ministry of Health was ready to approve the admission of drugs to stores - but only with three conditions: if the list of medicines is limited, the cash register for medicines is separate, and only a pharmacist or pharmacist can work with them.
The Ministry of Industry and Trade did not agree - and in 2014 insisted that stores should sell absolutely all medicines without a prescription! Compromise failed again. Moreover, Roszdravnadzor did not and still does not have the right to control the activities of non-specialized retailers. This was also warned by the director of the department of drug supply and regulation of the circulation of medical devices of the Ministry of Health of the Russian Federation Elena Maksimkina.
In 2015, she spoke out against drugs in stores and Minister of Health Veronika Skvortsova. She noticed that all large supermarkets already have pharmaceutical kiosks. “Therefore, it makes no sense to take and simply put it on the shelves. The question arises: why? - said the head of the Ministry of Health. The ministry did not plan to expand the list of over-the-counter drugs allowed for sale in grocery retail.But to be continued...
Unfortunately, the proposal did not receive due attention. CEO of DSM Group Sergey Shulyak. He proposed to allow the sale of medicines not in large stores in big cities, but in small rural ones. Where there is simply no pharmacy. The project of the head of the analytical company was still related to the problem of drug availability ...
In 2016, the pharmaceutical community could breathe a sigh of relief. Large retailers started not discussing the place of medicines on the supermarket shelf, but organizing their own pharmacy chains. Of course, a competitor who plans to open 3,300 pharmacies in his stores in 3 years is also a certain challenge for traditional pharmacy. But…
In August 2017 Deputy Prime Minister Igor Shuvalov again instructed the Ministry of Health to work out the issue of selling medicines in supermarkets. Early October Deputy Minister of Health Sergey Kraevoy noted that the ministry as a whole supports increasing the availability of medicines, subject to the medical principle “Do no harm”.
To the question of Medicinal Review, to what extent it is possible to implement this principle when selling medicines in supermarkets, I tried to answer co-founder of the project "Your Pharmacist" Vladimir Koryakin.
It is clear that the position of pharmacy workers and manufacturers will not be a weighty argument for the ministry and government, but one can enumerate some of the negative consequences of this decision for the Russian pharmacy business and, of course, for the health of Russians.
Everything will be “like in a pharmacy”?
The conditions must be the same for everyone. The blurring of the boundaries between the pharmacy and the store will lead to the fact that it will become more difficult for the first-timers to self-identify themselves, maintain their sense of belonging to a special profession, draw a line between themselves and the seller in the store. In addition, by doing so we discredit both the pharmaceutical industry and medical education. It turns out that anyone can sell medicines without having a special education?
In essence, after the adoption of the law, the existing order and rules for dispensing and storing medicines will be destroyed. And it’s not at all a fact that as a result, the availability of drugs will improve.
Medications must not only be dispensed correctly, but also stored correctly (temperature conditions, room humidity, special equipment, lighting, etc.) and disposed of if the expiration date has expired. This is a tedious and costly business. Where did the confidence come from that retail chains will comply with all the necessary prescriptions regarding medicines?
Recipe and frames
As for the open display in the trading floors, this will disrupt normal competition. Pharmacies not only sell the highly advertised over-the-counter (OTC) drugs that generate the highest profits, but they also perform important social functions by providing patients with less profitable prescription drugs. If this order is violated, the availability of prescription drugs will seriously deteriorate. Before allowing the sale of over-the-counter drugs in stores, it is necessary to reduce their list to a minimum.
Medicines are a product that cannot be dispensed without consulting a pharmacist or pharmacist. And stores selling pharmacy products can easily hire not only existing first-timers, but also students of pharmaceutical universities and colleges, as well as medical and pharmaceutical workers with invalid certificates. Or maybe they will do without consultant pharmacists.Counterfeit and control
In Russia, there is already a huge industry for the production and sale of counterfeit pharmaceutical products, and with the emergence of such a “wonderful” and absolutely uncontrolled distribution channel as Russian stores, the turnover of the counterfeit drugs market will undoubtedly grow at least an order of magnitude. Now the situation is controlled by Roszdravnadzor, but its powers do not apply to retail chains. Will supermarkets be as scrupulous about substandard medicines?
And the most important aspect that can be cited is not in favor of the legalization of the sale of drugs in supermarkets. This is the health of the population of Russia.
Since medicine is like food, then there is no harm to life?
If pills are sold next to food, Russians, already prone to self-medication, will generally have no restrictions on the use of pharmaceuticals. Both drugs (regardless of whether they are prescription or non-prescription) and dietary supplements can cause serious complications in patients if they are not taken correctly or combined. Not a single person, even remotely familiar with pharmacology, can deny such a statement.
Banal paracetamol is already today one of the most common causes of hospitalization in intensive care both in Russia and abroad, where this drug has long been considered the most dangerous in terms of the likelihood of poisoning. The result of self-treatment is, alas, resuscitation, and sometimes death.
In general, this is the list of good reasons why in our country even over-the-counter drugs cannot be sold in stores in the public domain.
The great desire of retailers to legalize the sale of medicines is understandable. They will not need to fulfill absolutely all the requirements and compliance for the sale of drugs (the presence of a pharmacist / pharmacist, a special room, lighting, temperature, equipment, etc.).
By whom and how will all stages of the sale and storage of medicines in retail chains be regulated and monitored?
The question is still extremely relevant and open.
As noted at the IX Pharmacy Summit head of "Rigla" Alexander Filippov: "Accessibility of a doctor - that's where it all starts ..."
Fake drugs, at best, simply will not be useful, at worst, they can cause irreparable harm to health, even death. Medicines in pharmacies are checked for quality by the relevant regulatory authorities, but they are able to cover only about 20% of medicines. How to buy a medicine in a pharmacy, avoiding a fake, we will tell in our article.
Types of fake drugs
There are 4 main types of counterfeit drugs in our pharmacies:
- "pacifiers" - preparations that do not contain substances specified in the instructions. Usually they put chalk, flour, starch, sugar instead. In principle, pacifiers are safe, but only as long as recovery does not depend on their use;
- medicines in which more expensive and effective ingredients are replaced by less effective cheap analogues. The result from the use of such drugs is many times lower than expected;
- with low dosage of active ingredients. The positive effect of their use is scanty;
- made in violation of technology. The composition and dosage in such medicines are within the normal range, but the quality is pretty lame due to non-compliance with the production regime. Such medicines may have a shorter shelf life than indicated on the package, or have a weak effect.
Another case of “wrong” drugs that cannot be attributed to falsification, but from which people suffer, is drug substitution. For example, instead of pills that reduce blood pressure, there may be pills in the blister that increase it.
For more information about drug counterfeiting, see the video:
What drugs are counterfeited most often?
In most cases, drugs are counterfeited:
- whose cost is in the price range from $4 to $35. It makes no sense to make very cheap ones, since their production simply may not pay off, and it is unprofitable to produce counterfeits of expensive drugs, since consumer demand for them is low;
- actively advertised. Advertising stimulates demand and guarantees high levels of sales and profits.
In most cases, the following are fake drugs in pharmacies:
Ways to identify counterfeit drugs
Alas, there is no way that would allow with 100% probability to select original pharmaceutical products and screen out counterfeit products. However, there are a number of rules, the observance of which will significantly reduce the chances of buying fake medicines in pharmacies.
According to the law, medicines are not subject to return in Ukraine and the Russian Federation. However, you can return a low-quality medicine, but you will have to provide an expert opinion proving that you were sold a counterfeit drug. In Ukraine, laboratory tests will have to be done at their own expense, while in Russia such a service is provided only to legal entities. So it is unlikely that you will be able to defend your right. Therefore, it is better to try to prevent this by checking medicines in pharmacies before buying.
