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  • Methadone Clients

    Hi, I just wondered how everyone else dealt with their methadone clients.

    Our branch of late has been losing business (just like the company), and my manager has recently been in touch with the lead at the local drug clinic and told them that we would accept any and all methadone clients. Now, our pharmacy sits on the outskirt of a very rough estate, and every week, almost daily, we have numerous thefts from the store. We have tried to, and failed in most cases, to get these thieves banned/arrested etc.

    And its these individuals that the drug clinics want to send to us for daily supervision of methadone. Our pharmacy is an all female pharmacy, with half the staff being >50 years. And the staff have raised concerns with regards to having these individuals coming in daily. The majority are worried for their safety, and do not want to face verbal/physical abuse.

    I know that we have to increase our profits, and methadone supervision is one way. But how can I increase the number of daily methadone clients if my staff feel threatened? And if I do not, how can I justify it to my area manager, especially with job losses on the cards in my area?

    Does anyone else face the same situation, and how do you deal with it?

  • #2
    Re: Methadone Clients

    i'm not sure if your pharmacy is an independent or belongs to a small chain but if it is then all the better, with regards to the crime, report every incidence however minor it is, also document and keep evidence of it yourself and then if nothing happens go to the local media, they love this sort of story, the police should come to see whats happening promptly.

    About the addicts, it would be easy to take them on but initially a bit of work would be required by the pharmacist, i.e. when they come in for the first time, the pharmacist needs to sit them down and outline a "zero" tolerance policy, where any theft would mean threatning behaviour towards the pharmacy and the staff under which the pharmacy is under no obligation to supply their meds.

    also if the head office insists on the blue scripts then ask for security personnel to be assigned to your store.
    We are the music makers, We are the dreamers of dreams and God damn we are that good

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    • #3
      Re: Methadone Clients

      Draw up a 'Good Behaviour Contract' for all methadone users to sign. Your head office my be able to send you one.

      It should cover items like times for collection, behaviour etc. Get all your methadone clients to read and sign that they understand what is being said.

      This helps to reduce problems. We have approx 40 methadone/subutex clients and also do needle exchange. We treat them as any other customer and they treat us with respect(most of the time!!).

      The last problem i remember having was last year when one of daily pick ups was caught stealing, her Rx was cancelled and she was barred instantly.

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      • #4
        Re: Methadone Clients

        You can, if necessary, ban people yourself.

        You just have to tell them they are barred from the premises. It may help to give it to them in writing, but it's not necessary.

        You don't need to give them any reason even.

        The new contract helps as there used to be a problem with barred people insisting you did their scripts, but now you can refuse to dispense any scripts from people who have, threaten to, or you believe will commit a criminal act.

        Once barred, coming onto the premises is criminal trespass (which the police should enforce for you) and any thieving becomes burgulary rather than shoplifting with appropriate heavier punishments.

        If head office won't back you up on this, I'd seriously consider getting a job where they have the faintest care for their staff instead.





        Edited to add: although this is under "methadone clients", I'm not picking on them as a group at all - most are fine especially if, as suggested above, you talk to them from the start.
        Employed again... paid holidays! Yipee

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        • #5
          Re: Methadone Clients

          Originally posted by scarlet80 View Post
          Hi, I just wondered how everyone else dealt with their methadone clients.
          Make sure that they know that you are "on their side"
          Get ahead of the game - get their phone numbers so that you can remind them that they need to collect if it's running late.
          Remind them when they need to pick up a new script. If the scripts come through the post find out if and why some don't arrive.
          Ask how they are getting on - take an interest - congratulate them on every success - encourage them to achieve their goals. Visit the local drug clinic and build up contacts with the team there.
          Address the patients concerns with the drug team -
          Is half day closing difficult for your clients?
          How easy is it to keep down a job with daily pick ups?
          Are they having any withdrawal affects, mood swings, restless legs?
          Thank them for coming in at quiet times.
          If things are going pear shaped (working away from home/mugged/ill) tell them to contact you sooner rather than later so that you can make arrangements with the clinic to help - get script to dispense a day later - approval from the clinic to deliver on this occasion etc.

          Our pharmacy is an all female pharmacy, with half the staff being >50 years. And the staff have raised concerns with regards to having these individuals coming in daily. The majority are worried for their safety, and do not want to face verbal/physical abuse.
          CCTV in the shop with a live feed to a security firm

          Works entrance for methadone clients
          Drug History Timeline - Lifeline Project and click on 1905

          Zero tolerance.

          But how can I increase the number of daily methadone clients if my staff feel threatened?
          Better training of the staff in assertiveness, CBT and motivational techniques.

          And if I do not, how can I justify it to my area manager, especially with job losses on the cards in my area?
          Ask for the support needed to achieve the targets. Change away from the mind set that you and your team are there to support your area manager, instead believe that the area manager is there to enable the support that you need to develop that branch.


          Does anyone else face the same situation, and how do you deal with it?
          Not quite. I came from a different direction and decided that the methadone market was a way for the branch to develop, and asked for the support from head office to do so.
          Four full days and two half days a week opening became five full days - thus negating the need for two morning collections.
          Lunch hour opening was introduced to facilitate client collection during court appearances. (and the clients knew it)
          Rarely had a problem while I was there - one case of abuse while I wasn't - once case of shoplifting while I was. Both clients banned - for a period.
          I still talked to them in the street afterwards while nipping out for a smoke, ask how they were getting on, and leave the the communication channels open. (Which did have the added benefit of keeping the rest of the family on my side)

          Throwing the first verse of the serenity prayer into the conversation can sometimes also help.

          Jeff

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          • #6
            Re: Methadone Clients

            We had a methadone patient buying us chocolate one day (never happened with "regular patients" ). Just treat them as normal customers. Don't forget those people have chosen to come off their addiction to other nastier stuff.

            My technique with them is to invade their personal space, talk to them eye to eye and show them empathy.

            Once the rules are established they tend to abide by them.

            Your main problem would be to make sure you don't stuff up the dispensing and gave the wrong dose as it already happened in NZ were someone died after a dispensing error by an experienced pharmacist.

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            • #7
              Re: Methadone Clients

              Originally posted by Shwampa View Post
              Your main problem would be to make sure you don't stuff up the dispensing and gave the wrong dose
              yes, easily done IMHO, because once you have befriended them, they can peck your head if the stuff isn't ready. I dispense it in a back room now, out of sight sound and head-pecking range, and ALWAYS get it checked.

              I would think the easiest way to kill an addict is to give them someone elses's supervised stuff when they are drunk. Always check their address, and explain why!

              I agree with the zero tolerance, the cancelling of scripts and the banning - it can be difficult on a Saturday though, as they can shout and rave for ages until the cops arrive.

              keep notes on the PMR of the hassling ones and don't have them back, I say.
              ....just my opinion

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