Background

Community pharmacy's contribution to the management of the significant problems associated with drug misuse is considerable. Some pharmacies provide specialist services such as supervised self-consumption of methadone and needle/syringe exchanges. Such services play an important role in reducing the leakage of prescribed drugs onto the black market and needle/syringe exchanges reduce the spread of blood borne infection. However such service provision can pose conflicts for pharmacists who provide services to the whole community and may be concerned about the effects of drug misuse services on other customers.

Aims

The study aims to determine whether pharmacy customers really are discouraged from using a pharmacy that offers services to drug misusers or whether this is a misperception by some pharmacists triggered by a particularly vociferous minority of customers. Are non-drug using patients/customers genuinely concerned and if so what are their specific concerns?

Methods

This explorative study used qualitative methods. Three different groups were interviewed about their views on pharmacies providing services to drug misusers: i) pharmacy customers, ii) local community councils which represents the wider community and iii) local drug forums which consist of health professionals involved in drug treatment. Interviews were conducted in 10 pharmacies, 5 in Aberdeen and 5 in Glasgow both areas of high drug misuse. The pharmacy customers were attending pharmacies with high involvement with drug misusers and low/no involvement with drug misusers and will be in city centre, suburban and rural locations. This purposive sample covered a range of factors, which might affect the views of those involved. Local community councils and drug forums were interviewed on their views regarding community pharmacies providing services to drug misusers in their area and whether this subject had ever been officially raised at their meetings.

Findings

The main themes arising were:

The majority of pharmacy customers are supportive of pharmacies offering services to drug misusers.

Pharmacy customers would prefer to see a private area provided for methadone consumption.

There is a concern that children should not witness the consumption of methadone.

Pharmacy customers do not always fully understand the reasons for offering methadone maintenance services.

Pharmacy customers were more supportive of needle exchange services than methadone maintenance dispensing.

Community councils were generally supportive but were less supportive of people from out with their area using pharmacies in their area.

Conclusion

There is general support for needle exchange services and support for methadone maintenance although customers would like this to be less visible. These findings are of relevance to individual pharmacists concerned about this area of service provision and to those involved in strategic planning of pharmacy drug misuse services.