Pubdate: Sun, 9 May 1999
Source: Sunday Times (UK)
Copyright: 1999 Times Newspapers Ltd.
Author: Stephen McGinty


When Christine Glover peers over her tortoiseshell spectacles and speaks of
the Incredible Hulk rampaging through her pharmacy, you imagine she has been
sipping her own supplies. But she is neither hallucinating nor exaggerating.

Glover, a reassuringly matronly woman, ran a quiet pharmacist's on West
Maitland Street in the Haymarket area of Edinburgh. It was frequented by
young mothers popping in for a packet of Pampers and pensioners collecting

But the small store became a battleground when heroin addicts came to
collect their supplies of methadone.

The anaemic men and women were transformed into roaring "bears" if their
"scripts" had been wrongly dated, making them too late to collect. Needless
to say, the young mothers and pensioners were increasingly frightened, as
was Glover.

She decided to sell her practice to Boots and moved to elegant premises on
William Street, where she offers personal consultations and homeopathic
remedies. Her experience is far from unique. It is the downside of
Edinburgh's methadone replacement programme, a programme that drug workers
often cite as a model for other cities.

Last week the Royal Pharmaceutical Society published the report of a
committee, chaired by Glover, that looked at the growing problem.

"One girl tried to collect methadone for a friend, which you can't do,"
remembers Glover. "When our assistant explained why, she went ballistic,
F-ing and blinding and threatening my staff. The other customers were
terrified and my assistant didn't come back to work for a month. It was the
next day the Incredible Hulk came in."

Muscled and tattooed, the man was so physically intimidating that staff felt
they couldn't cope and he was asked to go elsewhere for his supplies in
future. "My husband called later to ask, 'Have your chucked out a man in
blue anorak?' He was jumping all over the flower gardens at Haymarket
station. I was just glad he wasn't jumping on us."

The old world of the local Scottish chemist is long gone. The town
pharmacist was once respected as much for dispensing advice as medicine. The
most uncomfortable encounter such a professional was likely to experience
was a teenager buying condoms.

Now pharmacists have the stressful job of servicing Scotland's growing army
of drug addicts. Between 1992 and 1996 the number of NHS prescriptions of
methadone in Scotland more than doubled from 64,000 to 164,000. Pharmacy
inspectors recommend dispensaries limit themselves to a maximum of 10
methadone patients. But in Irvine Welsh's Edinburgh, which has the biggest
methadone programme in the country, pharmacists cope with 10 times that

Scotland's capital, one of Europe's most graceful cities, has a higher
proportion of middle-class housing than almost anywhere else in Britain. But
the trouble is not confined to the few deprived housing schemes made famous
by Trainspotting.

Peter Tinkler is aware of the problems. The owner of an independent
pharmacist on the Royal Mile, he enjoys a varied clientele: American and
Japanese tourists popping in

for camera film and midge repellent, office workers for cough mixtures or
headache pills. Then there are his 45 junkies, whose handwritten scripts sit
in a tidy bundle at the back of the shop. He says: "A lot of problems come
attached. While one is in for his methadone his four mates will try to
shoplift you blind. They'll steal anything, even aromatherapy oils."

Two incidents stick in his mind. A girl came in to collect not methadone,
but an alternative drug they did not have in stock. As he telephoned other
dispensaries to find it, the girl's boyfriend began to swear and beat her.

"My sales assistant told him to stop slapping her and he went absolutely
berserk, then ran out the shop. When the police picked him up they found out
he had committed a serious assault on a pensioner just before he came to the
shop. We were very lucky."

Another enraged addict once threatened to stab all the staff in the shop.
"Most you dismiss as bravado - but we believed him," says Tinkler.

The Royal Pharmaceutical Society report argued that rules on the dispensing
of methadone were hopelessly outdated. The committee collected evidence from
a number of Scottish pharmacists who want the regulations reviewed, a point
accepted last week by Jack Cunningham, the minister responsible for drugs

The strict misuse of drugs regulations were written in 1970 and designed for
administering methadone or morphine to terminally ill out-patients, not for
daily or weekly doses to heroin addicts. Today drugs such as methadone can
only be dispensed exactly as they are worded on the prescription; for
example 50ml on a Monday, Wednesday or Friday.

"The problem lies with the disorganised life of the user," says Glover. "He
may be in jail on a Monday and come to collect on a Tuesday and you can't
give it to him. So he gets very mad indeed. You have your staff and the
other customers to consider. There is also the terrible amount of time
arguing with people which can be better spent."

Her arguments are strongly supported by community pharmacists Alison
McKinnon and Jim Walker of Walker McKinnon. They have 100 addicts collecting
methadone each week from their practice in Edinburgh's Sighthill (the
location of the Robert Carlyle television drama Looking After Jo Jo). While
composing a time study for the Royal Pharmaceutical Society's report they
discovered they spent a full day each week catering to addicts' needs.

Both feel the rules more than compound their already-heavy workload. But
unlike some fellow professionals, both are happy to do the work.

"I feel it is very important to keep them in the community and not pushed
out into a ghetto," says Walker. "If that was the case it would be very hard
for them to come back into society when their addiction is at an end."

McKinnon's believes the recommended figure of 10 per pharamacist is
impractical. So, however, are the existing rules by which they are bound. "I
feel we do a good job but we if we fix the outdated rules and regulations we
could do a better job" she says.

Even if the changes are implemented, the sheer scale of addiction is
unlikely to lure back the many professionals

who have shut up the local shop to work in hospitals or city centre chains.

Glover, who charges her new customers A330 a time for a personal
consultation, has moved into a different world and doesn't intend to return.
"I don't miss the hassle at all," she says.

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