A pharmacist has been struck off the register for the supply of codeine linctus and Phenergan (promethazine) “for the purpose of misuse”, a General Pharmaceutical Council (GPhC) FtP committee determined at a hearing held between May 22 and 24.
Muhammad Qasim Ali Manzoor, registration number 2203578, sold the drugs to his “friend” between 2017 and 2020, knowing that they would be “abused in the form of a drug known as Lean”, according to the determination.
On the basis of text message evidence, the FtP committee found that Manzoor had “offered to supply and supplied” a fellow pharmacist, unnamed in the papers, with phenergan and codeine linctus - which was referred to as “Lean” in the correspondence.
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A witness clarified to the committee that promethazine and codeine linctus are combined to produce the recreational drug “Lean” - also known as “Purple Drank” and used for a “legal high” – according to the document.
The committee accepted that Manzoor, who was not present or represented at the hearing, had a previously unblemished record as a pharmacist and had not “repeated his actions”.
The regulator also accepted that there was “no direct evidence” of supply.
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Nevertheless, the committee inferred from the context of the messages provided as evidence and on “the balance of probabilities” that “supplies had taken place”.
And it said that Manzoor had “effectively admitted his involvement” in his statement to the regulator.
Suspicious messages
In April 2021, Manzoor’s “very serious” misconduct came to light during an investigation into “another pharmacist” who the investigator suspected of “stealing and selling drugs from his pharmacy”, the document revealed.
When inspected, the other pharmacist’s phone revealed “a large number of messages” between this pharmacist and “somebody recorded as Qasim”, it said.
These messages “appeared to discuss” the supply of the opioid codeine linctus and promethazine by “Qasim” to the other pharmacist, it added.
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A witness confirmed that the phone number recorded for “Qasim” was the same number that the GPhC had in its records for Manzoor, the document said.
Manzoor and the other pharmacist were well known to each other, having graduated “from the same university in the same year and month”, it added.
The messages revealed that the other pharmacist repeatedly asked Manzoor for promethazine - referred to as “prometh” and “pheng” - and a coded order for “bottles” of another substance ordered “alongside” the antihistamine and Lean ingredient, it said.
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In 2020, the other pharmacist dropped the pretence and asked Manzoor for “a set” of Lean, who gave his friend a time to collect the drugs, according to the document.
The committee determined that the other drug referred to throughout the correspondence was “more likely than not” codeine linctus, since this is the “other ingredient of Lean”.
“Sincere apologies”
Manzoor provided the GPhC’s investigating committee with a statement in September 2023, in which he provided his “sincere apologies”, the document revealed.
He said that “a close friend, another pharmacist” had asked to buy “over the counter (OTC) medications” from him.
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Manzoor conceded in the letter that he had sold the items “without proper consideration” and in doing so had “failed to uphold the standards” of the GPhC.
“This was a clear breach of trust and I acknowledge the gravity of my mistake,” he wrote.
“Inadequate” and “discouraging”
But the committee found that Manzoor’s statement was “consistent with him having knowingly supplied drugs for misuse” and was “not only inadequate but discouraging”.
It said that he “knew” that the drugs he was supplying to his pharmacist friend would be “very likely to be abused”.
And it found that the “informal nature of the messages” between Manzoor and his friend were “incompatible with supply for professional purposes”.
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The FtP committee determined that Manzoor had committed “serious” misconduct as he breached its standards by putting people “at risk of addiction and other harm”.
While he had “apparently developed some understanding that what he had done was wrong”, this did not demonstrate to the regulator “any understanding of why his misconduct was wrong”, it said.
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Manzoor did not provide the committee with “understanding” of his motives or evidence that there would be “no repetition”, it added.
It decided that a “severe sanction” was necessary and chose to remove Manzoor from the register and impose an interim suspension to cover the appeal period.
Read the determination in full here.
