Not someone else's problem
Pharmacists could state any number of reasons why they would choose not to take part in needle exchange services. Fears that customers will be driven away, that drug misusers might be drawn to their area or that their staff will be subject to abuse are just some of the thoughts they could have — not to mention the extra time required.
For some pharmacists, it is probably a case of “out of sight, out
of mind” — that by simply not having to witness needle exchange
first hand the problem will somehow just go away. But the fact of the
matter remains that drug misusers are here to stay.
Needle exchange programmes — including those offered by pharmacies — aim
to keep drug misusers healthy so that they are alive to seek help when
they decide to; having a drug misuser return to mainstream society as
a healthy and happy individual must be the ultimate goal.
This week’s News
feature (p185) looks at how needle exchange services
kicked off back in the late 1980s in response to the AIDS crisis. And
with the International AIDS Conference taking place in Toronto this coming
week (13–18 August) it is an opportune time to look at all aspects
of HIV infection (not just those relating to needle exchange) — The
Journal dedicates a page
of News to HIV in this issue (p182).
It is well known, however, that HIV is not the only health problem faced
by misusers. Hepatitis C infection is highly transmissible through sharing
not only used needles, but other injecting paraphernalia as well; hepatitis
C is insidious within the injecting drug user population. Severe injection
site injuries are another reality. The public health impact is irrefutable.
The facts are unpleasant but pharmacists need to be aware of why it is
so important for them to become involved, and pharmacies are certainly
well placed to provide convenient services.
Experts agree that there is a shortage of pharmacies offering needle
exchange programmes. They also say that the pharmacists who are already
providing needle exchange need to step up the level of service that they
offer. Is it enough to provide needle exchange to drug misusers — albeit
in a clean, unimposing environment — without offering advice on
staying healthy, safe sexual practices, or where to access treatment
programmes? The Journal would suggest it is not.
It is clear that pharmacists need to direct new energy — and understanding — into
needle exchange and other drug misuse services. In areas of the UK where
needle exchange services are sparse, pharmacists should not stand by
and allow the drug-misuse population to remain marginalised and without
a potential avenue into the health service.
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