Involvement of community pharmacists in the care of drug misusers: pharmacy-based supervision of methadone consumption

This article examines the feasibility and acceptability of a supervised consumption of methadone service from local community pharmacies. It builds upon the British Department of Health's recommendations to increase the involvement of community pharmacists in the care of addicted drug users and to expand the range of services they offer to drug users. The article also takes up the ongoing debate on regulating the structure of prescribing and dispensing of methadone and the Department of Health's suggestion to consider methods to reduce the diversion of methadone, for example via supervised consumption of methadone. The pharmacy-based supervised self-administration of methadone scheme (SSA) at the Camden and Islington Community Health Services Trust Substance Misuse Services (CTDS) in London has been found to be valuable by clients, pharmacists and keyworkers. All pharmacists involved regarded the project as workable and expressed their willingness to continue with the provision of supervised dispensing of methadone in the future. Clients stated as main advantages: local access, which saved them time and travelling, and the longer opening hours enabled them flexibility in managing their time. The main negative comments were related to lack of privacy when drinking their methadone within the pharmacy. Most keyworkers welcomed the SSA scheme as another dispensing option available. The fact that another responsible and accountable health professional was involved was positively perceived by the key workers. The Camden and Islington pilot project of providing a supervised consumption of methadone service from local community pharmacies has successfully put into practice the Department of Health's recommendations to increase the involvement of community pharmacists in the care of addicted drug users and to expand the involved health range of services they offer to drug users. This suggests a positive future for the practice and implementation of pharmacy-based self-administered provision of methadone.