Question 1g (answer Part 1)

The paper I'm working on is here

Poison scheduling info can be found here and here

The question is what is the legal classification of a cough syrup containing codeine 9mg/5ml and pseudoephedrine 30mg/5ml.

This is an interesting one.

You can start by thinking about whether there is any such cough medicine in your home country. Let's say for example if you are a UK pharmacist, do we sell any cough meds containing codeine and pseudoephedrine? Would the restricting drug which would ramp up the scheduling of this med be the codeine which may or may not be a dangerous drug, or pseudoephedrine, known for its illicit use of being converted into methamphetamine?

Codeine as a cough medicine has become a bit of a pariah, although in the UK it can be sold by a pharmacist without a prescription at the strength of 15mg/5ml. (We don't really like it though because of the potential for abuse and possible opioid related side-effects, but that is by the by.) Once you increase the strength, codeine becomes a POM, prescription only. Codeine 25mg/5ml liquid which is used for pain relief is prescription only.

The concept is similar in HK, below a certain threshold codeine is schedule 1, above it it becomes a schedule 3 and dangerous drug DD. You just need to find out what the cut off concentration is. The fact that it contains 9mg/5ml rather than 10mg might be a clue. Have a look here, codeine can be found under 'Alkaloids' (Don't ask me why they decided to do that, maybe in HK they like to make stuff like this seem more complicated than it should be).

Pseudoephedrine: this drug which started off as an innocent little sympathomimetic used for treating nasal congestion become controversial over the years as apparently people bought Sudafed from the pharmacy to turn into methamphetamine. Sounds kind of impressive, I have no idea how to do that and I'm a pharmacist. I remember when I worked in retail pharmacies we'd hide Sudafed out the back in the dispensary and go into a panic every time any one came in asking for it. The Sudafed team has now replaced pseudoephedrine with phenylephrine in most of its cold products. But it is still possible to buy Sudafed containing pseudoephedrine; in the UK and USA you need to ask the pharmacist for it, maybe kind of a step up from a 'Pharmacy' or P med. So that's kind of funny, like I'm supposed to look into the eyes of this person and determine whether they're a meth dealer or not. In HK such a drug may be considered a Schedule 1 drug where they take it a step further by stating in the legislation the pharmacist needs to actually know the buyer to be a 'fit and proper' person, and note down details of the transaction.

So, is pseudoephedrine a S1 drug in HK? Have a look.

Still confused? I can prepare a more full on answer for those who don't want to work it out and post it up later, go ahead and subscribe if you want to find out part 2 of this answer as soon as it comes out!