Pubdate: 3 May 1999 Source: Guardian, The (UK) Copyright: Guardian Media Group 1999 Contact: http://www.guardian.co.uk/ Author: Sarah Boseley, Health Correspondent METHADONE RULES PUT CHEMISTS AT RISK Pharmacists face threats and abuse daily from methadone users because of the out-dated rules on dispensing the drug and a steep rise in the numbers of heroin addicts. Jack Cunningham, the minister responsible for drugs policy, has accepted the Royal Pharmaceutical Society's argument that the regulations need to be reviewed to ensure the safety of pharmacists and their customers. The problem lies in the strict misuse of drugs regulations introduced in 1970 for methadone, which is prescribed for heroin addicts. To avoid abuse of the controlled drug, the pharmacist must comply exactly with the wording of the prescription. The drug can be dispensed only on the day stated and in the quantity stated, and can be collected only by the addict. But routine and regulations and the chaotic life of the junkie do not go well together. 'The prescription may say dispense on Monday, Wednesday and Friday,' said Christine Glover, a pharmacist in Edinburgh who chaired the society's working party on the issue. 'But on Monday he is in the police cells or knocked out. On Tuesday he turns up, and I can't give it to him. Immediately I have got a really angry bear in the pharmacy who is steaming because he hasn't had yesterday's drug either and withdrawal symptoms are setting in. 'One pharmacist in Liverpool was threatened with an axe. You have your staff and the other patients to worry about the little old lady, with some junkie screaming in the pharmacy. It is all ghastly. 'If the doctor sent me a letter in his own handwriting saying 'let Fred have it', it is still not legal.' Bank holidays could be a big problem if the doctor had not thought to double the dose. When the regulations came in there might have been one methadone user a day in a pharmacy. Now 'colleagues in Edinburgh do 100 a day' said Mrs Glover. 'I used to have between 12 and 20 a day. [Now] you are having to put up methadone on a daily basis for 20 or 50 people, and the legislation is largely out of sync.' Between 1995 and 1996 the number of notified drug misusers in the UK rose by 17 per cent to 43,400. Between 1991 and 1996 NHS methadone prescriptions for addicts more than doubled to 891,100. 'Heroin addiction programmes have kicked in," said Mrs Glover. 'People are given drugs so they are not out on the streets or in Marks and Spencer stealing to buy them.' The original intention of the regulations was good, she said: to safeguard a potent medication. But the society hoped the review would 'result in some leeway for the pharmacists in interpreting prescriptions'. Pharmacists had a role in fighting the drug problem. They supervised many addicts as they took their methadone dose, ensuring they were not 'jumped by someone who will take it off them' once out of the pharmacy door. 'The vast majority see it as caring for people who have problems... Some have been coming for years." - --- MAP posted-by: Mike Gogulski