The Pharmaceutical Journal Vol 264 No 7100 p883
June 10, 2000 Letters

Drug abuse

Clarification please

From Mr M. S. Finberg, MRPharmS

SIR,-In the PJ of March 25, (p463) there was the report of an interesting discussion about harm minimisation programmes in the Law and Ethics Committee of the Council.
Unfortunately this whole area is still very unclear and certainly none of the six locum locations I work at has consistent views on the subject.
Well over a year ago, I wrote to the PJ on this very subject (PJ, October 24, 1998, p664) and an official reply to my query was published noting that the Society's working party on services to drug misusers (PJ, March 21, 1998, p418) had made recommendations about making ascorbic acid powder and citric acid more widely available.
Armed with this official advice I told all my shops they could safely leave these items on display. At one of these pharmacies a police inspector later called and informed the pharmacist that the law was being broken by making citric acid freely available. I later met a police inspector at a different pharmacy, and was told it was very much up to the individual inspector and how he felt.
Going through this and recent advice in the PJ we have:

• The Law and Ethics Committee agreeing to support the supply by pharmacists of citric acid for harm minimisation in Glasgow
• The committee noting that current Council policy is that citric acid and similar products should not be sold for the purpose of assisting the use of illicit drugs (in line with Home Office advice that sale or supply would be illegal under section 9a of the Misuse of Drugs Act 1971)
• On the understanding that section 9 had never been intended to restrict products such as citric acid, no action being envisaged against pharmacists in the interest of harm limitation as part of recognised needle and syringe exchange (does this mean that only pharmacies carrying out needle exchange can sell citric acid, etc, in line with only these pharmacies being allowed to sell or exchange disposable syringes?)
• The committee confirming that it would support a professional decision to supply citric acid in appropriate circumstances

So, lots of confusion and probably none of us any the wiser - should we or shouldn't we?
I have been to a lecture for pharmacists given by Turning Point, which is very keen for pharmacists to be a part of the whole harm minimisation scheme. It also pointed out that many licensed methadone addicts inject heroin, and that the methadone eases the heroin craving. So we should not be surprised when our regulars ask for a red pack. (It is doubtful that many GPs issuing methadone prescriptions would agree!)
I would welcome firm guidance for all pharmacists and not just those in Glasgow as to official policy in harm minimisation in regard to drug misusers.

M. Finberg
Ilminster, Somerset