Methadone

[Paddy]

Hi Pharmacists

I was in my local chemists shop the other day, when I saw one of those rotten junkies getting his green liquid (mefadone?). He gave the chemist a right load of stick, because he had to wait for me to get my stuff first (about 30 secs in total later !). I hung about looking at shampoo for a bit. I was a bit worried for the staff as they are all women and are always nice to me. The chemist always gives me good advice, and seems to know more then my doctor if I ask her any questions.

This shop had a kind of private area where he could have gone, but he didn't want to. He just drank it right in front of everyone, nastily asked for some water, then had a go at the chemist cos he had to wait - he said he had a taxi outside!

My question is do you have to have these people? Why can't they go to a drug rehab type of place? I just don't think it's right young lasses like these mainly are should have to deal with scum like that. Are all druggies like this or did I just see a bad one?

:?

Paddy

[admin]

Paddy

It seems you had a bad experience. Not all addicts are of the nature of the individual you witnessed. Most are in fact no problem to the pharmacy staff, and many are very nice people. I once had a problem aggressive customer, and one of my regular methadone clients waited, like you did, to see that I was safe.

On the subject of troublesome methadone clients, most pharmacies make them sign an agreement which has amongst other things, a code of conduct in it. This is usually agreed with the local GP practice, and often the local drug clinics etc. The GP's usually make them sign a similiar agreement which often has conduct in the pharmacy, as well as in the surgery, terms within it.

You must also remember that pharmacies, surgeries etc are businesses, and as such have to create revenue. In some parts of the UK pharmacists are paid a fee to witness people taking their methadone. This ensures they drink it on site, and stops the illegal sale of it to possible vulnerable people. If you have never taken methadone before, it doesn't take much to actually kill you!

If they become a persistent problem we will contact their GP and they will usually agree to cancel their prescription. This is a good example of how good communication between health care professionals can work to everyone's benefit.

[jpgreen44]

Methadone addicts who behave like this rapidly run out of pharmacies willing to dispense their script. We do not go to work to be abused, threatened or shouted at or witness our stock being thieved and loyal customers intimidated. The first instance of this results in their script being cancelled. If they continue with this behaviour then they just end up having to travel greated distances every day.

[admin]

JP

Nice reply. Do the GP's have an agreement with you so you can actually cancel the script, or do you ring and make sure it's ok first?

How can you make them travel great distances - do the pharmacies in your place of work network with each other on this?

I just wondered because in the areas I work in going to work and being abused, shouted at etc seem to be an accepted part of the job. There are quite a few posts on this subject so I won't say anymore.

Thanking you in anticipation of your reply.

[Jeff]

I'm a mug - I enjoy my patients - I mainly enjoy the challenging one's.

The taxi waiting outside could be because he's due in court/at work and can't afford to be late - and feels like shit as the previous days dose is wearing off.

Supervised methadone does keep methadone off the streets - but daily supervision at the same pharmacy every day doesn't fit in well with holding down a job - particularly if your employer doesn't know of your habit.

Yes the addict ought to be spoken to - so as to work out how to better address his needs - seeing a life change from the chaotic to stability is one of the professionally most rewarding aspects of this job. It's long term involvement with patients who actually have a chance of getting better. (Most patients with chronic conditions usually just get older and worse - diabetes - COPD dont get better)

IMO a glass of water should have been given with the methadone as a matter of course anyway.

Jeff

[Racer]

I have a zero tolerance policy on abusive people in my pharmacy. I make it clear what is and what isn't acceptable and do not hesitate to ban someone who misbehaves.

R

[admin]

Jeff/Racer

As I travel around I find the supervision policy on methadone consumption is very different. In some towns there is virtually no supervision, and people take away large quantities of not only methadone, but diamorphine amps and other things as well. Do you think a national policy on this would be better?

I have known literally hundreds of addicts, and can think of one or two that have actually kicked methadone. Some PCT's seem to be willing to prescribe them other drugs alongside/instead of methadone, and some do not. Some welcome supervision, and some do not. It seems like a bit of a lottery to me.

[Zoggite]

PLEASE don't tell me there are pharmacies who actually supervise the administration of diamorphine amps!!!
Asking subutex patients to pull their tongue out at me is bad enough...!!

[admin]

Zoogite

No I didn't mean we supervise amps! It's just that I once handed over 56 100mg diamorphine amps to one guy, and I'm not sure he'll ever reduce that dose, because of the cash he can make from selling it!

Mister Pharmacist runs a big needle ex/methadone scheme. I think he has over 150 methadone people alone.

[Zoggite]

Well, I hope the local police force recognises Mister Pharmacist's positive impact on the "petty crime"figures in his area!
If nothing else, that alone justifies methadone prescribing in my eyes.
The cost to Society of alcohol and tobacco addiction is far greater than that to "hard" drugs.