The Pharmaceutical Journal
Vol 270 No 7252 p782
7 June 2003

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Wolverhampton YMCA's drug advice and mentoring service (www.drug-chat.co.uk)

Shared care addiction scheme starts

A seamless addiction service involving hospital and community pharmacists will be piloted this month in Wolverhampton. It involves acute care in a specialist clinic with long-term management for stable patients in the community.

The specialist service began in February 2002, and it is now being extended to four community pharmacies. Sonia Ofori-Dei, pharmacist in addiction services at the specialist clinic at Horizon House, Wolverhampton, explained that the reasons for involving community pharmacists are two-fold. "The first driver was the number of people wanting to use the specialist service, which far exceeded the initial target of 50 people." She added that using supervised consumption in community pharmacies would also help to avoid secondary dependence on the specialist service. At present, around 50 patients a day are seen at the specialist clinical for supervised methadone, plus a small additional number for buprenorphine and amphetamines. The clinic is only open during the week so weekend doses are either given to the patient to take away or the patient is given a prescription to be dispensed in the community.

Under the new shared care scheme, patients will initially be seen in the specialist clinic. Once a patient has been stabilised and is giving "clean" urine samples then, with the agreement of their keyworker and doctor, they will be released to the community pharmacy part of the scheme where they will receive supervised methadone. "We hope this will result in a seamless situation," said Ms Ofori-Dei. "If the patient is stable they will be managed in the community but if problems occur then the patient can be referred back to the specialist clinic."

Community pharmacies have been selected on the basis of their prior experience with methadone patients and their location near to areas with large numbers of methadone users. General practitioners are also keen on the scheme: they will prescribe methadone to some of the patients transferred to community care.

"We hope that extending the service to the community will lead to an increase in number of people able to use the service," Ms Ofori-Dei commented.

Funding for the scheme has been agreed. Further information about funding can be obtained from Pauline Tyler-Morrell at Horizon House (tel 01902 444030).