Pharmacists' Opinions on the Policy for Controlling the Sale of Drugs That Have Been Abused in Thailand.

Abstract

Background and objectives: Medication abuse is a major global issue due to its health risks. In Thailand, regulation of drug sales is overseen by the Thai Food and Drug Administration (FDA). This study aimed to examine pharmacists' opinions on policies regarding the control and monitoring of the sales of drug that have been abused in Thailand.

Methods: A mixed-method design was employed, combining a survey of 440 pharmacy pharmacists and 77 regulatory enforcement pharmacists selected through accidental sampling with in-depth interviews of 17 pharmacists recruited via purposive and snowball sampling until data saturation. Survey data were analyzed descriptively, while interview data were examined using content analysis. Data were collected nationwide in Thailand between April and October 2023.

Results: Over 80% of respondents understood the policy measures, yet most reported limited effectiveness and unintended consequences. Nearly 90% indicated that maintaining drug sales records drives high-risk buyers to underground markets while increasing workloads and leading some pharmacies to discontinue sales. Respondents favored eliminating or digitalizing records. The FDA Reporter system was viewed as useful, but incomplete and retrospective data limited its effectiveness. Participants recommended real-time integration across the supply chain. Restrictions on retail and wholesale quantities were considered only partially effective, often burdening patients requiring continuous treatment. By contrast, requiring pharmacists to comply with Good Pharmacy Practice (GPP) and personally dispense dangerous drugs was regarded as the most effective measure. Interviews also align with the survey and highlighted persistent issues such as "hanging-license pharmacies" and emphasized stricter enforcement, intersectoral collaboration, and education for at-risk groups.

Conclusion: Current measures to control drug sales remain ineffective, leading to diversion, increased workloads, and discontinued sales. Enforcing Good Pharmacy Practice (GPP) has proven more effective. Policy strengthening should focus on modernizing electronic reporting, eliminating rigid quantity limits, and enforcing pharmacist presence during operating hours for safe, responsible drug distribution.