Ask the Pharmacists

Why Are Nonprescription Items Behind the Counter?

As I was waiting in line to pick up a prescription the other day, my gaze fell upon shelves behind the counter that hold an odd assortment of items, among them: Breathe Right strips for snoring, smoking-cessation kits, sitz baths for hemorrhoids (or whatever), Gillette Mach3 razors and a "ZNP Bar" for advanced dandruff.

I was 16th in a line that was barely creeping toward the register, so I had time to wonder why this motley lineup of items is guarded. Why boxes of benign alcohol swabs, hydrogen peroxide and urine-testing strips? How come the motion-sickness medicine Bonine is behind the counter but not its competitor Dramamine?

I wondered if the placement was designed to help deter theft -- statistics show baby formula, for instance, can be a tempting target. But I found it oh-so-curious that anyone would risk jail time for saline nasal gel.

In addition to being a subject of curiosity for consumers, nonprescription items that are held hostage behind pharmacy counters are hot topics lately in drugstore circles. The collection of items there reflects, in a big way, turmoil that is roiling the pharmacy profession.

There is, of course, the huge national, political, professional, women's rights and religious ruckus that Plan B has kicked up. Plan B is the "morning-after" contraceptive some pharmacists are refusing to stock or fill on religious or moral grounds. It is a massive subject in itself that I will flee here in favor of smaller and less-touchy ones such as . . .

Mucus. As anyone who recently has had a stuffy nose knows, most pharmacies in the Washington area and in more than 30 states have put nonprescription cold tablets containing pseudoephedrine (the active ingredient in nasal decongestants such as Sudafed, Tylenol Cold and Claritin D) behind the pharmacy counter. This is part of an effort to help law enforcement cut down on the manufacture of methamphetamines. Pseudoephedrine is a component of that illegal street drug.

Making customers ask for cold tablets is a good example of a decision that has plusses and minuses for drugstores and pharmacists, says Rob Eder, the editor of Drug Store News.

On one hand, the practice cuts down on theft. Eder says putting items behind a counter and making their purchase obligatory there helps with theft by putting an extra set of eyeballs on them.

On the other hand, the placement creates what retailers call a "barrier to purchase." You may find it embarrassing to ask for a sitz bath. Or there may be such a long line at the pharmacy that you just skip the stop and go home.

Obviously, if you leave without buying, the store loses money.

But who decides what goes there? Totally different items reside behind the counters at my local CVS drug store, Target and Giant. For example, I saw zinc oxide at Target but nowhere else.

Janet Engle says every store makes up its own list. Engle is a former president of the American Pharmacists Association and associate dean of the University of Illinois at Chicago College of Pharmacy.