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."