SMMGP - Substance Misuse Management Good Practice

Substance Misuse Management Good Practice

Supporting good practice in drug and alcohol treatment

Post-its from Practice:
My local pharmacists - vital partners and unsung heroes (Apr 2012)

Ahmed, one of my local pharmacists rang the other day saying "Chris, don't forget to alter the scripts for the upcoming Easter bank holidays. We are open on the Saturday, but I hear several pharmacies are closed on the Saturday as well." I thanked him for the important reminder as it would affect so many prescriptions and we then went on to discuss several of our joint patients: Jack who is doing so well, Jean who is still struggling with her anxiety but "enjoys going into the pharmacy" daily etc.

The conversation reminded me again how lucky I am in Kilburn having at least 5 excellent pharmacies very close. The pharmacist is a key individual in drug treatment being successful, but the counter staff are also essential to make the pharmacy a welcoming place without stigma. The pharmacist sees our patients much more frequently than I do and often, like Jean, on a daily basis. She often remarks that Ahmed is her main support worker. She feels he cares and never judges, even when her time-keeping is not the best! He also doesn't judge when she occasionally asks for a clean needle and syringe, but does advice her on overdose prevention. Ahmed was the reason Jean came to us for treatment in the first place. It had taken him a while, as her previous experiences had been poor, but she had now been with us for nearly a year and the changes have been dramatic. He commented how rewarding it was to have seen these changes and to have been part of them. "Jean even smiles when she comes in now!"

Ahmed and his local colleagues are also a crucial part of the team that keeps people in treatment when things are not going so well. Jack, mentioned in our call, was currently doing well, but this hadn't been the case until recently. He was missing pick-ups, presenting after drinking or having used other drugs. For the first few weeks it felt as if we were always on the phone to each other as he had missed one, two or more days. But Ahmed never gave up, never got angry, reminded him about loss of tolerance and overdose risk, and kept sending him back to me until he stabilised.

Pharmacists are also extremely helpful with drug interactions with prescribed and over-the counter medications and doses. Most of the time, I think I get prescriptions right but I feel reassured that there is another good check before it is dispensed. We always ring the pharmacist before sending a new patient, as it's good to start that relationship. I view them as part of the team, and not just someone who dispenses the medication.

They, as with GPs, need to work within their professional guidelines and occasionally they need to remind us of those. The pharmacy contract which came into effect in England in 2005, enabled pharmacists to potentially play even a greater role in the treatment of people who use drugs, as historically the community pharmacist has been an underused resource. These changes and improved training has supported more pharmacists to become involved, which can only benefit patients, GPs and other healthcare providers.

I couldn't work without my "vital partners" the pharmacists and feel incredibly fortunate that I am so blessed to have so many good ones around. I also know this is not unique as having to transfer 2 patients recently to other areas it was easier to find a friendly pharmacist than a friendly drug service!

A big thank you to all the community pharmacists as I sing praises to you, so often the unsung heroes, and an essential part of the drug and alcohol treatment system. We couldn't do it without you.

- Dr Chris Ford
GP Lonsdale Medical Centre, Clinical Director for IDHDP, and a Member of the Board of SMMGP