Leonardo Blair, Staff Reporter
PHARMACISTS ACROSS the island are reporting that the popular 'morning after' pill, Postinor 2, is being abused by persons including schoolchildren, and they are calling on officials in the Ministry of Health to rethink the decision which made the pill available over the counter some six months ago.
They are also reporting falling condom sales which they have attributed to easier access to Postinor 2.
The pharmacists fear that the drop in condom sales and the increasing demand for the 'morning after' pill are clear indications that more persons are engaging in unprotected sex.
ABSTINENCE NO OPTION
This comes against the background of tomorrow being World AIDS Day, and the country's burgeoning AIDS data which show that between January and June 2003, 516 new cases of AIDS and 415 new HIV infections were reported.
"I hope it doesn't turn out into an AIDS/STD epidemic. In some places, I know the condom sales have actually dropped because of the availability of Postinor 2. We are worried, what about AIDS and STDs," says Juliet Duncan, a pharmacist at Crystal Pharmacy along Red Hills Road.
"Now that they have made it over the counter, everybody is just walking in for Postinor 2. It's complicated. In speaking to some of them (consumers) they are just thinking about the here and now. Abstinence is no longer an option. We have had to increase stock," said another pharmacist at the Hughenden Pharmacy, who did not wish to be named for this story.
"Once 10 packs of Postinor 2 would last for a month or a month and a half, now it lasts for two weeks or 10 days depending on the season. I am worried about the trend. It appears that persons are becoming more reckless. Some persons even come to purchase the pill before they have sex, just in case," she added.
When contacted for a comment on the situation, Health Minister, John Junor, told The Sunday Gleaner that, "This is the first time I am hearing this so I could not comment on it."
The pill, which is effective in preventing pregnancies when taken up to 72 hours after unprotected sex, was reclassified in May, when it was gazetted under the Pharmacy Act and the Food and Drug Act and placed in a category that allows it to be dispensed by a pharmacist after direct counselling with the consumer. Users are advised not to use the emergency contraceptive more than twice in a 28-day period.
Aleti Rajani, a pharmacist at Moodie's Pharmacy in New Kingston, told The Sunday Gleaner that: "We are selling about four times more Postinor 2 now. We ordered 50 packs and stocks finished in 10 days. Every day on average, we sell about five or six packs."
Ms. Rajani, who is also reporting a slump in condom sales, has linked this to the availability of the Postinor 2 and suggested that Postinor 2 should have remained a prescription drug.
"I personally feel that Postinor 2 should be a prescription item. They (people) are not going for the other contraceptives as much because some of them, even school children, are now depending on Postinor 2," she says.
NO STOCK KEPT
In Montego Bay, some pharmacists are so angry at the situation that they don't even keep the drug in stock. Others, who provide it to users, only do so because it has been sanctioned by the Ministry of Health.
"I oppose Postinor 2 personally. I think it's doing more harm than good. We only sell it because the Government says we should," said one Montego Bay pharmacist. "The pill is being abused. Down here, one person will go to three, four different pharmacies and you can't stop them because you can only go by what they tell you during counselling."
Peter Daley, an accountant at the Hilton's Pharmacy in Montego Bay, further explained, "it is not 25 and 26 year olds that are asking for it (Postinor 2), it is much younger."
In response to the situation, Stephen Delapenha, president of the Pharmacy Owners Association said last week: "I don't know how pharmacists are going to be able to monitor any abuse. It would really be up to the person to tell the truth. Individuals I am sure are probably abusing it but unless you are going to put it back on the list (for prescriptions), I don't know."
Chairman of the Pharmacy Council, Granville Forbes, explained that several concerns were raised about the drug during meetings with members of the Council."If the thing (Postinor 2) has been deregulated you can't stop people from buying it. (But) In my humble view it's like opening Pandora's box. We have to be emphasising to people that it is an emergency contraceptive every time. I am not even sure that putting it back in the doctor's hand will necessarily help either," he said.
In July, National Family Planning Board (NFPB) officials cited the necessity for easier access to Postinor 2 as a huge step to preventing unwanted pregnancies.They argued that the drug which lowers the risk of pregnancy by about 85 per cent, "if used correctly", would help prevent unwanted pregnancies.
But, many of the pharmacists argue that the move will not do anything to help Jamaica's AIDS/STD situation in the long run.
NFPB Executive Director, Dr. Olivia McDonald, maintained earlier this year that "Expanding access (to Postinor 2) is a major policy initiative towards the reduction of unplanned pregnancies."
She said that problems with the old method included that the requirement of a prescription was actively harming women by prolonging access to the drug.
Postinor 2, which is not a substitute for regular contraceptives, is distributed locally by Medimpex Jamaica Limited.It works for eight out of 10 people who use it correctly and is also used if persons have missed two or more regular contraceptive pills, forgot to get the contraceptive injection on time or were forced to have unprotected sex.
