Recent reporting by ITV’s Tonight Programme (28 May 2026) indicates that around 10 million people in the UK may have put themselves at risk of dependency or addiction to codeine-based medicines, while broader concerns are emerging around a ‘hidden’ problem involving a range of over‑the‑counter (OTC) products, including painkillers, sleeping aids and nasal sprays.
The same reporting highlights that significant numbers of patients exceed recommended usage periods, with some continuing codeine use well beyond the advised maximum of three days.
These findings reinforce long-standing concerns within the pharmacist profession about the risks associated with medicines that are readily accessible but carry addiction potential.
Pharmacists are a critical safeguard in preventing misuse
P medicines are classified specifically because they require professional oversight and clinical judgement at the point of supply. Pharmacists play a vital role in:
- Assessing patient suitability
- Identifying signs of misuse or dependency
- Advising on safe duration and dosing
- Refusing supply where necessary.
The ITV report also highlights that individuals can attempt to bypass safeguards through ‘pharmacy hopping’, illustrating the importance of vigilant, consistent professional intervention at every supply point.
Strong professional opposition to ‘facilitated self‑selection’
The PDA has consistently opposed proposals to introduce or expand facilitated self‑selection of P medicines, where patients can browse and select higher‑risk medicines from open shelves prior to any pharmacist interaction.
A recent PDA survey found that:
- 94% of pharmacists oppose facilitated self‑selection
- 98% are concerned about inappropriate medicine selection
- 92% are worried about reduced pharmacist oversight
- 80% cite risks of theft or misuse.
Pharmacists report that self-selection models risk shifting decision‑making away from clinical professionals and into a retail environment, increasing the potential for harm.
Patient safety must come before convenience and commercial interests
In 2024, the Royal Pharmaceutical Society (now the Royal College of Pharmacy) revised its position on facilitated self‑selection, having advocated for change partly because it would provide a way for pharmacy businesses to increase their over-the-counter sales.
In its formal response to the change, the PDA warned that such models:
- Risk inappropriate use and misdiagnosis, as patients may rely on advertising, Packaging or the experience of others
- Fail to guarantee pharmacist intervention at the point of decision-making
- Increase the likelihood of adverse drug reactions, particularly for patients with complex medical needs or polypharmacy.
The PDA has stressed that “patient safety must remain paramount”, and that any system which allows medicine selection without prior clinical input introduces unacceptable risks.
The emerging evidence of OTC misuse and dependency further strengthens the case against relaxing controls on access to higher‑risk medicines.
The case for a Single Patient Record
Alongside maintaining robust supply safeguards, the PDA supports the development and implementation of a Single Patient Record (SPR) across the NHS.
A joined‑up digital record would:
- Provide pharmacists with access to a patient’s full medication history
- Improve visibility of prescriptions, comorbidities, and previous interventions
- Enable better clinical decision‑making at the point of supply
- Reduce the risk of duplication, interactions, and inappropriate use.
Government plans for a national SPR in England aim to allow clinicians across settings to access a complete, shared view of patient information, improving safety and coordination of care. Including interactions with pharmacists on over-the-counter medicines would support the identification of patients experiencing addiction or taking medicines outside of recommended ranges.
For community pharmacists, access to this information would deliver a fuller picture of patient care, helping to prevent harm and support appropriate medicine use.
Conclusion
The rise in reported dependency linked to OTC and pharmacy medicines demonstrates that products available to buy in a pharmacy are not without risk. Pharmacists are highly trained healthcare professionals whose involvement in the supply of P medicines provides an essential clinical safeguard for the public.
The PDA reiterates that:
- Access to medicines with known risks must not be relaxed
- Facilitated self‑selection undermines patient safety and professional oversight
- Investment in systems such as a Single Patient Record is key to strengthening safe, effective pharmacy practice.
Ensuring that pharmacist expertise remains central to the supply of medicines will be critical to addressing emerging public health risks and protecting patients in an increasingly complex healthcare environment.
Learn more
- PDA’s response to the RPS Position on facilitated self-selection of P medicines
- Overwhelming majority of pharmacists oppose the facilitated self-selection of P medicines
- PDA challenges RPS on its ‘open display of P medicines’ policy review
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