As a Pharmacist one of the very first things that we are taught about in school is that every medication has a risks and benefits. The idea behind taking a medication is that its risks should be less than the potential benefit. With some medications the risks are just too high for the benefits. Typically those are highly restricted of illegal medications. Other medications have very low risks with a well defined benefit. Those are typically over the counter medications.
Image source: Dall-e
However, just because it is LESS risk doesn't mean it is no risk and things can certainly go wrong even with medications that people see as harmless!
Never ask a Pharmacist what is the worst that can happen
Now when I was a younger pharmacist I will admit that I had a customer who made light of the risks involved with over the counter medications. Their flippant attitude irritated me and when they asked me point blank "What is the worst that can happen with Ibuprofen" I answered them honestly. "SJS/TEN or Stevens Johnsons, Toxical Epidermal Necrolysis. Or in laymans terms. All the skin falls off your body and you in in ICU for months recovering provided your organs don't shut down causing death". They of course thought I was full of crap so I showed them a newspaper article about a little girl wrapped up like a mummy in ICU from childrens Advil.
I will admit that my employer was horrified that I would say such a thing. As a more seasoned pharmacist I am a little more judicious in my declaration of potential risks. However, the fact remains, EVERY medication has a potential risk.
Three stories of medication gone wrong
Now of course I could state numerous cases where things went wrong as a Pharmacist. However, I'll limit it to just three different stories. One that happened to me. One that happened to my son. One that I heard about in the Pharmacy and I'll admit it brought me a little guilty pleasure.
When the Pharmacist gets burnt by medication.
Now for myself I am acutely aware of everything that can go wrong with a medication. That makes me very wary of medication so I will only use the smallest effective dose for the least amount of time.
One time I was on a very long bus trip. 36 hours on a bus from Terrace to Nelson, BC. Awful trip, not recommended. However, about halfway through the trip I was getting queasy from the rocking on the bus. As a resourceful pharmacist I came prepared with my Dimenhydrinate (Gravol). I had the chewable orange flavoured version for children as I knew I wouldn't have water on the trip.
Wow. Did I miscalculate. Dimenhydrinate has an awful flavour. The orange didn't help. In fact it was so awful it left my mouth feeling burned with a disgusting aftertaste for the hour and a half it took me to get to the next town and a drink of water. I swore I would never sell that stuff to anyone ever again Ugh.
The pharmacists son
Now just because I know about medication doesn't mean my son has been born with my respect for medication. I did indeed tell him about the dangers of medication and especially street drugs. However that didn't stop him from getting in trouble when he was about 14. I was happily sleeping when my son comes into my words with those dreaded first words "Dad, don't be mad but....". Nothing ever good follows those words. He said he was feeling sick and thought he was going to die. I thought he should ask his mom as she's the nurse and better able to triage. Then he said he took a bunch of pills and my heart sank. I got into Pharmacist mode really quick and asked what he took. He told me caffeine tablets. Caffeine? Those shouldn't cause too much trouble. I mean I hate them as they aren't nearly useful enough for their side effects but...
I think asked "How many did you take?" I figured one or two tablets wasn't going to hurt. Then he told me "Well, my co-worker usually takes 8.....So, I thought 10 would be good".
Disbelief
10 Caffeine tablets? That's about the same as 14 cups of coffee for a slender 14 year old. Now my first thought was Are you a dumbass??? ... But as a caring father my words were. "I'm certain you are feeling pretty awful however, you aren't likely to suffer any long term effects from it. How about I stay up with you while we ride this out and we can talk to distract you from the problem".
I figured I'd much rather him know he can come to me in the future and I'll work with him than blast him for his error and not be in the loop if something went wrong in the future.
A customer who stole medication
Now one thing that I ran into in the Pharmacy just left me a bit stunned and honestly chuckling to myself a bit.
You see there was a person who stole his grandmother's medication. Now I don't have any sympathy for people who steal necessary medication from the elderly. If you are stealing it from your grandmother I just think that's a special kind of awful. However, this person was addicted to narcotic medications and when someone is truly addicted, ethics go out the window.
Typically this person would use 10 (Ten) Oxycodone 5mg tablets. Little blue tablets with a 5 on them. When this gentleman found some Oxy 5 in his grandmother's stash he stole them and quickly took 10 tablets. Unfortunately for him they were not Oxycodone 5mg they were Oxybutynin 5mg. Now Oxybutynin is used for people with overactive bladder to keep them from urinating uncontrollably.
For this person it meant he could not pee. His bladder kept filling but he had no way to void the urine. It started as uncomfortable. Then painful. Then a trip to the ER with very serious pain. He had to pee so badly but couldn't! They had to insert a catheter but the muscles were clenched shut so it was a pretty forceful insertion into an area where forceful insertion isn't at all pleasant.
Take home lesson: Don't steal grandma's medication! And if you do, well, at least make sure it is the RIGHT medication!
In the end medication should be treated with respect but not fear. Yes there are things that can go wrong. I know this both professionally and personally. If you look at all the bad things you may skip out on a much needed medication. If you don't treat medication with respect you can get badly burned. In the end always weight the potential benefit VS the potential issues. Make an informed decision and usually you will end up with a much better result.
Of course you may have a different opinion.
If so (or even if you agree with me), I always love getting feedback.
Thanks for reading.
Ethics and addiction really don’t belong in the same sentence. Terrible things happen because of addictions, and when it gets to the point of stealing your own grandmother’s medicine, we know it’s something that’s already crossed the line.
I absolutely agree. However addiction is ugly and people deserve respect addict or not. Love the person, not the addiction. As a pharmacist labeling someone as an "addict" and judging is easy. Seeing them as a person who needs help fighting against a huge problem is hard. However if you pharmacist isn't going to help you battle addiction who do you turn to?
Still when I hear someone stealing their own grandmother's medicine to fuel an addiction it makes me sad and angry 😡. That's why it does give me some guilty pleasure of serves you right when they get a tube inserted somewhere....unpleasant