Introduction
Pharmacist supervised consumption of methadone is well established in the U.K. and is a recent development in Ireland. Daily supervised consumption leads to higher contact between the pharmacist and the client group. Often contracts are established which describe expected behaviour of both parties. Breech of contract often leads to withholding of one or more doses of methadone.

Objectives
During 1997-1998, the authors undertook a large study of community pharmacists in Dublin and Glasgow to determine the level of service provision to drug misusers and to ascertain attitudes towards such provision and future service developments. This paper describes two aspects of this study which was (i) whether pharmacists had ever withheld a dose in the past and (ii) what circumstances would lead to them withholding a dose of methadone.

Methods
In November 1997 a postal questionnaire, containing 45 items, was sent to all community pharmacists in Dublin and Glasgow. The questionnaire was piloted in 12 community pharmacies in both Dublin and Glasgow. The questionnaire was anonymous and no reminder was sent.

Results and Discussion
The response rates for the questionnaires were 50% (146/291) and 56% (112/200) for Dublin and Glasgow respectively. The percentages of pharmacies in Dublin and Glasgow that provided methadone services for drug misusers were 38% (55/146) and 80% (90/112) respectively. Overall 9 pharmacies (16%) provided supervised dispensing of methadone on six or more days per week to a total of 151 patients (21%) in Dublin. This is in contrast to the situation in Glasgow where 76 pharmacies (84%) provided this same supervised service to a total of 1191 patients (76%). In Glasgow 71% of pharmacists had written procedures/guidelines for the provision of methadone services. This was significantly greater than the 40% of Dublin pharmacists who had written procedures/guidelines in place (chi-squared=13.7, 1df, p< 0.001). The percentage of pharmacies that had patient contracts was similar in Glasgow and Dublin (48% and 42% respectively). Of these, the percentage that had written contracts was lower in Glasgow than in Dublin (51% versus 74% respectively).

The percentages of pharmacists who indicated that they had withheld/refused a dose were 54% and 40% for Glasgow and Dublin respectively. Pharmacists were asked to state in what circumstances they would withhold a dose of methadone. Free format text responses could be classified into 7 main categories.

Conclusion
Glasgow pharmacists tended to refuse doses more often than Dublin pharmacists. The circumstances in which pharmacists would withhold a dose were similar for the two groups, however the ranking varied strikingly. The categories, ranking and samples of respondents comments will be presented.