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Methadone Woes

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  • Methadone Woes

    The local drug dependency unit posted a methadone Rx to my pharmacy for a well know patient, who had been banned by me some time before for abusive language. The unit had been informed but still decided to send me his Rx.

    One of the benefits of living in a village is that we know all our patients/customers so that we knew the address on the Rx was not where this patient stayed although the CHI number was the same as the one in our PMR.. Knowing this patient as being thoroughly manipulative I phoned the drug dependency unit to check on my suspicions.

    It transpires that they had THREE patients with the SAME name but different addresses which in itself in this area should have set alarm bells ringing. or so you would think.

    Finally I said with rising incredulity " Don't tell me they all have the same CHI number.? "

    After a very long pregnant silence came the reply " Oh...So they do.! "

    At that point they possibly decided too much had been said and airily informed me that they would deal with this matter themselves.So be it.

    As a pharmacist, parent of teenagers and a taxpayer to boot I feel totally disgusted at such cavalier attitudes. Makes me wonder does giving free methadone for life solve anything.?
    Last edited by ymdawd; 6, March 2008, 09:58 PM.

  • #2
    Re: Methadone Woes

    Sorry for my ignorance but whats a CHI number?

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    • #3
      Re: Methadone Woes

      CHI or the Community Health Index number is totally exclusive to an individual.
      Don't know about elsewhere but here in Scotland the ideal is that every single Rx carries, or should carry, the CHI number for that patient.

      It allows 100% correct identification of a patient which at times can be very useful indeed in a busy pharmacy. I use it constantly.

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      • #4
        Re: Methadone Woes

        The first six numbers are the date of birth. I believe the last four numbers are generated at random. Adding the two together and you have a CHI number.

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        • #5
          Re: Methadone Woes

          One final constant irritation is why oh why are methadone patients allowed to to take methadone away from the pharmacy.? It has to be a major source of illegal methadone on the black market.

          My personal record of dispensing takeaway methadone was 3600ml. (Yes that was 3.6l.) Yes it was legal and yes the doctor concerned still does it.

          Simply put ALL methadone should be supervised.!!

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          • #6
            Re: Methadone Woes

            I can see where your frustrtaion comes from, when I was a pre-reg I regularly saw methadone patients with take home scripts dealing their methadone outside our store. The cheek of it. The worst was a subutex patient - supervised, scraping it from his gums and giving it to another person, again outside the store and the other chap without a second though shoves it straight in his gob. Nice!

            But I dont think we can say ALL methadone patients should be supervised.
            I have had a few patients who work, yes addicts are capable of honest work, therefore they can not be tied to a specific pharmacy every day. I had one guy who worked night shifts and his mother came to collect once a week.

            Surely its up to their liaison worker at the addiction centre to show a little common sense wether a patient is supervised or not.

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            • #7
              Re: Methadone Woes

              Sure I can understand, even agree to some extent, with what you say. But as with life in general it is the actions of a selfish self-centred few which spoil it for the odd genuine addict who is trying to make something of their life.

              No I believe that ALL methadone patients should be supervised ONLY in a pharmacy.

              This would have the laudable aim of minimising the amounts of methadone reaching the streets. I can still "see" the worried father who brought in a coca-cola bottle with the remains of a green liquid that his young teenage son had brought home. That sure was a sticky moment trying to explain to him how it had most likely happened

              Liason workers have had the wool pulled over their eyes far too often for me to have much faith in their ability to show common-sense. The fact that so many patients get to take their methadone away is to my mind proof of that.
              By all means speak to them, help them, advise them etc. but trust them.? Anyone who does is a fool heading rapidly for a fall.

              Sorry but it has been a long week and there's still tomorrow.

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              • #8
                Re: Methadone Woes

                I'm quite sure that a lot of the difficulty over acceptance by drugs workers of the need for supervised methadone comes from the word 'supervised'.

                As a generality, drugs workers tend to see themselves as working in partnership with their 'clients' -- and the use of the word client should tell you how sensitive they are over words.

                So, I always refer to methadone patients having 'observed' consumption of methadone since I feel that this is a less pejorative term and more nearly fits the concept of being concerned that the right quantity of the drug goes down the right throat.

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                • #9
                  Re: Methadone Woes

                  Originally posted by ymdawd View Post
                  CHI or the Community Health Index number is totally exclusive to an individual.
                  Don't know about elsewhere but here in Scotland the ideal is that
                  Ymdawd, I thought you must be welsh with a y and w in your name.

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                  • #10
                    Re: Methadone Woes

                    Originally posted by Robatcymraeg View Post
                    As a generality, drugs workers tend to see themselves as working in partnership with their 'clients' -- and the use of the word client should tell you how sensitive they are over words.

                    So, I always refer to methadone patients having 'observed' consumption of methadone since I feel that this is a less pejorative term and more nearly fits the concept of being concerned that the right quantity of the drug goes down the right throat.
                    "Service users" is another term I have come across.

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