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Journal of Public Health Advance Access originally published online on November 6, 2007
Journal of Public Health 2007 29(4):350-357; doi:10.1093/pubmed/fdm064
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© The Author 2007, Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved

Community pharmacy harm reduction services for drug misusers: national service delivery and professional attitude development over a decade in Scotland



Catriona Matheson, Senior Research Fellow

Christine M. Bond, Professor

Michela Tinelli, Research Assistant
Department of General Practice and Primary Care, Foresterhill Health Centre, University of Aberdeen, Westburn Road, Aberdeen AB25 2AY, UK

Address correspondence to Catriona Matheson, E-mail: c.i.math{at}abdn.ac.uk


  Abstract

Background Community pharmacy contributes to drug misuse management and reduced spread of blood-borne disease through distributing clean needles and substitute drug dispensing. This paper reports a third Scotland-wide survey of pharmacies enabling service delivery to be charted over a decade.

Methods A cross-sectional postal questionnaire of all Scottish pharmacies (n = 1166) was undertaken. Descriptive data were collected on services provided, attitudes, training and demography. Data were compared with data from 1995 and 2000.

Results Needle exchange provision increased slightly to 12.5% from 9.7% (2000) and 8.6% (1995). The mean number of needle exchange clients increased significantly to 37.7 from 20.3 (2000) and 12.5 (1995). Methadone was dispensed by 79.1% of respondents, and 90.9% of those supervised self-administration. The total number of methadone patients increased to 12 400 from 8809 in 2000 and 3387 in 1995. Of those taking methadone, 57% have supervised self-administration. A quarter dispensed buprenorphine to 190 patients. Attitudes improved significantly but training levels have not changed since 2000.

Conclusion More commitment to harm reduction was evident through improved attitudes and increased services. Service delivery has increased more for dispensing services than for needle exchange. Strategies for delivering future needle exchange and substitute dispensing services are required if demand approaches capacity.

Keywords: community pharmacy, dispensing, drug misuse, needle exchange, treatment


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