Community pharmacists in Glasgow have used medicine that can reverse the effects of opioid overdoses more than 20 times since a programme to allow pharmacies to store kits to administer in an emergency began last year.
Naloxone is also being handed out to frontline workers, such as housing association staff, in a bid to tackle rising drug deaths.
In a presentation to the Pharmacy Management Celtic nations conference, members of the Scottish Drug Deaths Task Force gave an insight into the public health emergency being caused by easily available and cheap street drugs, making the case for community pharmacy to play a central role in intervening with people who are already using their services.
Dr Carole Hunter, Lead Pharmacist for Alcohol and Drug Services at NHS Greater Glasgow and Clyde – and the Royal Pharmaceutical Society’s representative on the Drug Death Task Force – says a key initiative has been to provide community pharmacies with naloxone kits:
“These are for the staff to use themselves in an emergency.
“You may think that that doesn’t happen, but in Glasgow alone, we have had 25 confirmed reports where the pharmacist and their staff have administered naloxone to people either within or in the close vicinity of the pharmacy, and I know that that is being replicated because we’ve had reports from Grampian to the Borders.”
The programme has already seen naloxone distributed to winter shelters and homeless hostels to drug users so they can support their peers, families and people when they leave prison.
Meanwhile, ambulance crews carry packs to give out following calls to non-fatal overdoses, and a pilot has begun in three pilot sites in Scotland to equip 700 frontline police officers with kits.
Last week two police officers administered Naloxone for the first time just two hours after being trained in its use.
“We were all ridiculously excited by the first effective safe textbook use by a police officer [last week],” Dr Hunter told the conference.
Dr Hunter cited research showing drug deaths in central Glasgow have all been in more deprived communities, pointing out there are usually more community pharmacies per head of the population in deprived areas than more affluent ones.
“Over the last year we have had unprecedented challenges. We’re in the covid situation, a public health emergency but, in Scotland, that came on top of the public health emergency of drug deaths. In Glasgow we also have an HIV outbreak as well.
“I think we don’t have to seek out people using drugs. This group of people are already there, they are attending the community pharmacy and the question each and every one of us has to ask is: are we making the most use of that opportunity to help to address what is a major public health issue in Scotland, the issue of drug-related deaths?”
Another speaker at the session, Chair of the Scottish Drug Deaths Task Force and Professor in Substance Use at the University of Stirling Catriona Matheson, points to post-mortem evidence showing the number of different drugs people had in their system being greater now than before, and growth in so-called “street” versions of prescribed drugs.
Professor Matheson described the situation as “grim”: “The benzodiazepines are not coming from prescribed benzodiazepines. In the past, it was the prescribed benzos that were leading the street market and now it is very much illicit benzodiazepines.
“The illicit benzodiazepines are so abundant and so cheap and of such poor quality.”
Dr Hunter says that market forces were at play and making things worse: “Drugs have never been so cheap or so freely available.
“They have always been around. In the late 80s, a tenner bag of heroin cost you a tenner. It still costs you a tenner today. And it actually weighs more than it did in the late 80s. So, even if it only kept pace with inflation, it should be at least £140.
“It’s the same for benzos. We’ve had temazepam which would have cost you £5 or £10 a tablet then – they cost pennies nowadays.
“You have to factor that into the whole equation.”
Professor Matheson said the continuing roll-out of the naloxone programme coupled with the other initiatives that have been set in motion, mean that drug use in Scotland should not be the death sentence that it once was:
“It has certainly been a very grim few years.
“With the work the Task Force is doing and now with government putting a lot of extra money and resource behind drug treatments and services, and care more generally, we hope that we will finally be able to make a change.”
by John Macgill