Buying a lot of Tylenol 1 in Winnipeg as easy as asking

Full disclosure: The only things in my medicine cabinet are Aleve and Rub A535. Growing up with a psychiatric nurse for a mother, I have a healthy respect for opiods and the dangers of addiction. While many over-the-counter meds are safe, there are those that can lead an unsuspecting user down a dangerous path. I police my own drug use with a nerdy vigilance.

But this morning, my job dictates I step out of that cautious comfort zone and see how many Tylenol 1s I can buy in inner-city pharmacies.

Tylenol 1s are generally considered safe in small doses — one of the reasons it is available without a prescription. Each one packs 300 milligrams of acetaminophen, 15 mg of caffeine and eight mg of codeine. It's that last ingredient that makes them so popular among those with addictions.

The first pharmacy I hit up is close to the Health Sciences Centre. Most of the places we spoke with in preliminary research told us they limited sale of Tylenol 1 to no more than one of the 200 tablet bottles.

"Go big or go home," I think.

"Can I help you?," asks the technician.

"Yes. I'd like two 200s of Tylenol 1."

"We don't sell more than one bottle of the 200s," she replies. I notice something subtle in her body language.  She signals the other tech working next to her. There is some eye contact with the pharmacist.

"Why not?" I press.

"Have you had T-1s before?" she asks.

"Yes." I say. "And T-3s."

"Would you like to speak with the pharmacist?"

He is ushered over and asks me why I am looking for pain relief and is very firm: He can't sell me that many Tylenol 1s. I can tell he doesn't like confrontation. Turns out I am right.

Serious concern in the area

I finally introduce myself and explain I'm doing research. He's relieved. He tells me Tylenol 1 abuse is a serious concern in the area.

Once a day he finds himself having to take repeat customers aside to talk about their frequent attempts to buy the drug. He says he tries to direct them to their doctors to get to the root of the underlying issue but many just disappear after his intervention.

Next I stride into a Main Street pharmacy.

"Can I help you?" asks the veteran pharmacist from Sudan.

"Yes. I'd like some T-1s please."

"Why?"

"Back pain."

He eyes me suspiciously. "How many?"

"How many can I get?"

He folds his arms and looks me up and down. I feel like I have been sent to the principal's office. I push but he flat-out refuses to sell me more than one bottle.

I'm getting the sense that the more I push, the less likely I am to even get that. He warns me about my liver, and tells me if I have back issues there might be a better drug on the market if I went to my family doctor. I give up and tell him why I am being such a difficult customer.

Baha Elzayat tells me he has been working as a pharmacist for 40 years, and in the last few years he has seen a sharp increase in Tylenol 1 abuse. He tells me he's been forced to track buyers himself and refuse sales to repeat customers. He's hoping for tougher regulation around the drug.

A little further down Main, I try again for multiple bottles of the 200 tabs.

"We don't carry any more than 100 tab bottles," the technician informs me. She's giving me a hard look.

"Well can I buy a couple of bottles of the 100 tabs?"

"No," she says curtly. "That's against policy."

In the back the pharmacist looks up. "Sell it to her," he barks.

The technician challenges him: "What, are we changing the rules now?"

"Yes," he asserts.

He asks me if I have had them before. I say yes. He tells me not to take more than eight and walks away.

I walk out with two bottles of the 100s. 

Last stop of the morning

On my last stop of the morning I meet pharmacist Azahir Ali. The second the word "T-1" leaves my lips the grilling begins.

Ali has a gentle maternal way about her. First, she wants to know why I want them, then she wants to know if I have spoken with my doctor about my symptoms.

"It could be," she tells me. "You need a different better drug … or maybe you have something else that is causing the back pain."

She has a bottle of 200s in her hands but she isn't just going to hand them over. She tells me how toxic they can be to my liver if I take too many.

I push for another bottle. She tells me no. I ask why. She tells me 200 tablets is quite a lot and I don't need to stockpile it. I nudge her again for another bottle. She tells me it isn't illegal to sell me more but she will not do it.

"You can probably get someone else to sell you more down the street but I won't," she flatly informs me.

She is clearly reluctant to sell me the one bottle she has finally bagged and I end the gambit.

Ali confides that she believes Tylenol 1 should be prescription-only — that likely would require Health Canada to reclassify it . She thinks Tylenol 1 should be prescribed before Tylenol 3s are considered and that both doctors and pharmacists need to spend more time with patients and ask more questions to prevent abuse.

So does she cross-examine everyone as closely as she did with me?

She says, like others, she tracks frequent buyers and refuses to sell to some but she has no idea who has already bought another dose down the road. She'd like to be able to track sales of the drug across the province to safeguard customers.

I walk out. In the space of two short hours, I could have had as many as 800 Tylenol 1 capsules on my hands — even from the pharmacists who had deep reservations about whether I needed the pills or not.

It was that easy. My mother and my liver would be horrified.