Interview with Warvin Newsletter-Handling of Medications in the Kurdish Region

A picture showing how an individual is allowed to sell medications without having to have a proper pharmacy attire on, name tag or a pharmacy technician licensing

1. What are the requirements for storing medicine?

By law, every medication has to be accompanied by a package insert. All information regarding storage content is contained within the package insert. All retail drug stores should abide by this package insert for the storage requirements of the medications.  Some medications require to be kept at room temperature, while others require being stored in a fridge.

2. In Kurdistan, we don’t have specialized stores for keeping medicine, what are the consequences?

When the medication is stored under improper environments, the medication is considered adulterated and not good for the use by the public.  Some of the consequences of adulterated medication are loss of efficacy and stability, shortening of the medication’s shelf-life, etc.

3. Is keeping medicine at home a healthy behavior? Some patients are storing those medicines that they used to use, is that healthy?

Every medication bottle comes with an expiration date.  Many times the pharmacies have to repackage the medications because pills come in big bottles.  By the law, the repacking expiration date should be a year from the date of repacking or 25% of the remaining time to the expiration date on the manufacturer’s label. It is very unlikely that patients are aware of this fact when they choose to store medications to be used for later.  Patients should therefore be counseled about this fact and that the medications that they are prescribed with should be taken as directed until finished.  Patients should also be advised against sharing their medications with other family members.

4. Pharmacies are selling medicines to patients without a doctor’s prescription, what are the influences of that on patient’s health? Some of those who are selling medicines are not qualified to do so, what are the consequences of that?

I’d like to cut this into two questions and try to answer each separately.  So from what I understand is that Pharmacists are allowed to sell medication without the need for a doctor’s prescription.  If so, pharmacists are allowed to diagnose in the region.  How are pharmacists able to diagnose patients without diagnostically testing them? This action will lead to lifelong consequences on the patient.  The patient might end up taking a medicine that s/he does not necessarily need.  The pharmacist is incapable of incorporating some facts that the physician is in power of before prescribing.

So I guess what I am trying to say here is that we, as pharmacists, are taught on how to therapeutically manage a disease state, counsel, dispense, compound and store medications under proper conditions. We are prevented from diagnosing and encouraged to refer the patient to their health care provider as much as possible.

The second part of the question is that you have some individuals dispense medications that are not qualified pharmacists.  Are we dispensing candy or medications here?  How is the individual able to read/write a doctor’s order if they fail to have some sort of knowledge in medicine?  Plus how is this person able to prevent over-utilization, under-usage, drug-drug interaction, drug-disease interactions if they are not licensed pharmacists? Many times, as a pharmacist, I had to call the doctor to see if s/he was aware that his patient was already taking a certain medication before prescribing him with a drug in the prescription order?  We pharmacists are the drug experts and we constantly need to bring awareness to the physicians about some vital pharmacology facts. 

5. What are the risks of using medicines in Kurdistan given all of those problems with medicine’s qualities, and limited awareness of the public?

I have listed some problems in the aforementioned questions. The number one victim of the poor handling and dispensing of the medications without a doubt is the patient.  I owe the problems we face in the pharmacy policy here in the region to the education system.  Looking at the curriculum and talking to some students in the schools of pharmacy, I noticed that the system is not patient-centered.  Why do you want to be a pharmacist, should be the number one question schools should address students with before admitting them into schools. If their passion is not to help patients, then they should perhaps change their career path.  The curriculum should focus on teaching the students on how to make the best choice for the patient when it comes to efficacy, safety, ease of use and cost of the medication. 


Taking medicine for an ailment is not necessarily the answer, is what we fail to teach the public about. Patients should be encouraged to do some life style modifications. If patients fail to improve with life style changes (diet, exercise, lessen stress, etc), then perhaps taking a medicine should be the second line-option. Pharmacists also fail to understand that every medication you give to the patient comes with an adverse event. So taking a pill for an ailment is not necessarily the best option sometime.   

6.A large number of stores which sell herbal medicines exist in Kurdistan. Is that the case in other countries? What are the differences between herbal medicines and other drugs.

Yes!  Every pharmacy you visit has a special aisle for herbal supplements. Many supplements interact with medications, which can lead to over/under efficacy of the medicine. Because patients can get herbal supplements without a doctor’s prescription, pharmacist can play a huge role here to counsel patients on the intake of these supplements and to prevent potential herbal-drug interaction. 

The difference between herbal supplements and drugs is the indication.  Food and drug administration (FDA) (in the United States) prevents supplements from indicating that their use prevents or cures a disease.  The makers of the supplements are, however, allowed to state that the content in the herbal supplements enhances functioning of a system in the body. Supplement medications don’t cure or treat a disease but used to fill in a missing vitamin or a co-factor in the body to enhance functioning.