The Pharmaceutical Journal
Vol 269 No 7218 p493
5 October 2002

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British Pharmaceutical Conference 2002 summary

Practice research lecture: Myths about pharmacists and drug users

There are several myths that community pharmacists will not provide services for drug misusers, Dr Janie Sheridan, associate professor, Auckland school of pharmacy, New Zealand, said. Her work, undertaken initially at the School of Pharmacy, London University, and then at the National Addiction Centre, has found evidence to explode these myths.

It has often been said that "community pharmacists will not provide services for drug misusers", but a in a national survey carried out in 1995, Dr Sheridan and her colleagues at the School of Pharmacy found that half the pharmacies in England and Wales were dispensing Controlled Drugs for misusers, one in five were taking part in needle and syringe exchange (NSE) schemes and 24 per cent were selling injecting equipment. A subsequent survey of 36 NSE schemes covering 440 pharmacies in the four former Thames regions found that they were making an average of 50 transactions in a four-week period, involving an average of 17 clients, of whom 14 were regulars. These pharmacies were being paid around £1 a day as a retainer and around £1 for each pack exchanged. "Not a huge amount of money," Dr Sheridan said. "Many pharmacists said that it did not compensate for the stock losses they were suffering through shoplifting."

Another erroneous statement was that "providing services for drug misusers is fraught with problems". In the NSE review, pharmacists reported that drug misusers being violent or dealing in drugs in the pharmacy was rare. However, shoplifting and dealing with intoxicated users was common. "Pharmacists carried on providing services despite this," Dr Sheridan noted.

Looking at supervised methadone consumption, Dr Sheridan said that before 1999 guidance for general practitioners on prescribing CDs was lax. Drugs that might be subject to diversion on to the black market should normally be prescribed in daily doses. In 1995, her survey found that 40 per cent of these drugs were being prescribed in either six or seven instalments for each week's treatment, but 40 per cent were weekly and a few were fortnightly or monthly. There were also variations in the prescribing of tablets and ampoules, which are more frequently diverted, but it was difficult to see any overall pattern to the prescribing.

Since new guidance was issued in England in 1999, prescribing habits had become more regular and supervised consumption of methadone, which had been going on in Scotland for some years, was introduced with few problems other than concerns about privacy in pharmacies.

As well as pharmacists, pharmacy staff also seem mostly happy with providing services for drug misusers, Dr Sheridan's research has found. "A more positive attitude towards misusers is linked to being involved with service provision."