From Mr N. W. Mitchell, MRPharmS
SIR,-I would like to bring to the attention of the Society a trend that is increasingly affecting its members practising community pharmacy, whether they are aware of it or not.
I work as a pharmacist on a housing estate on the south side of Birmingham. The trend with which I am concerned is the prescribing of various benzodiazepines to supplement or ease an addiction to another drug. The main drugs tend to be temazepam, diazepam and nitrazepam. It appears that these drugs have considerable street value and are, therefore, being sold on by the individuals for whom they are being prescribed. This means that any way that the quantity to be obtained can be increased will be attempted.
Colleagues and I have noticed a sharp increase in the number of prescriptions that are being "doctored" to receive inflated quantities. They are not all as easy to spot as diazepam 2mg, bd, quantity 19. When a prescription like this arrives in the pharmacy, extreme pressure is placed upon the individual having to refuse the supply, a task that has to be carried out while trying to avoid a conflict and protecting staff and customers. This is very difficult when the culprit sees us as attempting to hold back his or her business. Stolen prescriptions being written for benzodiazepines is another issue we are faced with.
I do not see why the pharmacy should have to be the battleground for these issues as we often are for exemption checks. Fortunately, my local general practitioners have been most helpful in either computer generating most prescriptions for benzodiazepines or using words and figures for quantities.
I feel so strongly about this that I would go as far as to say that changes need to be made to the Misuse of Drugs Act 1971 to stay at least one step ahead of the knowledgeable misuser or abuser, and hopefully avoid the problems that temazepam gave us simply being shifted to another drug in the same group.
A simple task being carried out by a GP could make life safer for us as pharmacists and the community, and reduce wastage of taxpayers money and the GP's drugs budget.
What becomes of the unfortunate pharmacist who fails to spot an altered quantity. Will he or she be visited by the drug squad or Society inspector, etc, and be reprimanded?
After all, we would all like to examine prescriptions for irregularities and be able to contact the GP to confirm quantities, but is this feasible? How do we contact a GP on a Saturday or Sunday? We are health care professionals who like to channel our energies into looking at prescriptions from a clinical aspect. Leaving us with the role of prescription policing alone is unfair as well as unsafe.
I would be interested to hear of the "experiences" of other pharmacists, as to whether this practice is as widespread as I think it is.
Nat Mitchell
Birmingham