Needle exchange

[mm45]

I have agreed to do a locum in a pharmacy and have discovered they do a needle exchange scheme. This is the first time I am to locum in a pharmacy with such a scheme. Is this a PCT led scheme similar to EHC that I will not be able to participate in as I am not accredited or is it a scheme that I will be expected to participate in?

[shan]

Don't worry, you will not even know when the staff has handed over the pack On a serious note, it is not like the EHC, it is a Govt run scheme and once the pharmacy has agreed you have to provide the scheme (as you get paid for each pack supplied) unless you find it is not safe or you are not happy to supply to a customer thinking it will be misused (whatever that means)

Shan

[crit care]

Am i right in assuming the main users of the needle exchange system are drug users? i can see the logic behind it, cutting down infection rates and making it safer for them, but surely should we be advocating such a service. Surely it looks from the outside that us as pharmacists are advocating the use of drug taking??

[johnep]

All to do with harm reduction. I struggled at first with supplying syringes, citric acid etc. But, if you supply an addict with what they need to avoid HIV/hepatitis C , then perhaps they will not infect your sister.
johnep

[crit care]

so in essence we are sending them to an early grave of a drugs overdose or death by drugs, its a bit like equippinga murderer with a weapon?!?

but i see your point in harm reduction..yes reduction to others, but shouldn't we be looking at ways of reducing harm to the aptient themselves

[johnep]

Not a murderer but a suicide. However, people have been convicted of infecting others with HIV.
We reduce harm by supplying the 'paraphernalia' , heating cups, swabs, condoms, info on infections, getting those on 2ml syringes (usually means into the neck or femoral veins) to be checked over at the clinic. Apart from locking them up, what would you suggest?
Methadone is also harm reduction in stopping muggings, burglaries etc. All very sordid but part of modern life.
johnep

[crit care]

but at least by supplying the methadone we are doing so in a controlled manner, and we know what we are supplying..by giving out needles and syringes, god only knows what could be going into them....

i don't think i can come up with any suggestions...it was more an ironic observation that as health professionals we are encouraging people to go injecting...(just a thought)

[hibernia]

...it was more an ironic observation that as health professionals we are encouraging people to go injecting...(just a thought)

Is it encouraging them or just facillitating them in a decision they have made already?
You can argue either way but the chances are that even if you don't supply them with clean needles they are unlikely to just stop injecting. Being addicted means you will do whatever it takes to get your fix. Even when clean needles are easily available addicts still use dirty ones if it is handier.

[mm45]

So do I need to be accredited with the local PCT before taking part in this scheme as a locum?

[shan]

Not sure, as this varies from PCT to PCT actually you may need to ask the regular pharmacist as to where to seek information.

Shan