Community pharmacy harm reduction services for drug misusers: national service delivery and professional attitude development over a decade in Scotland.
BACKGROUND
Community pharmacy contributes to drug misuse management and reduced spread of blood-borne disease through distributing clean needles and substitute drug dispensing. This paper reports a third Scotland-wide survey of pharmacies enabling service delivery to be charted over a decade.


METHODS
A cross-sectional postal questionnaire of all Scottish pharmacies (n=1166) was undertaken. Descriptive data were collected on services provided, attitudes, training and demography. Data were compared with data from 1995 and 2000.


RESULTS
Needle exchange provision increased slightly to 12.5% from 9.7% (2000) and 8.6% (1995). The mean number of needle exchange clients increased significantly to 37.7 from 20.3 (2000) and 12.5 (1995). Methadone was dispensed by 79.1% of respondents, and 90.9% of those supervised self-administration. The total number of methadone patients increased to 12 400 from 8809 in 2000 and 3387 in 1995. Of those taking methadone, 57% have supervised self-administration. A quarter dispensed buprenorphine to 190 patients. Attitudes improved significantly but training levels have not changed since 2000.


CONCLUSIONS
More commitment to harm reduction was evident through improved attitudes and increased services. Service delivery has increased more for dispensing services than for needle exchange. Strategies for delivering future needle exchange and substitute dispensing services are required if demand approaches capacity.
Matheson
Catriona
C
Department of General Practice and Primary Care, Foresterhill Health Centre, University of Aberdeen, Westburn Road, Aberdeen AB25 2AY, UK. c.i.math@abdn.ac.uk
Bond
Christine M
CM
Tinelli
Michela
M
D000293:Adolescent; D000328:Adult; D000368:Aged; D000701:Analgesics, Opioid / Q000008:administration & dosage; D001291:Attitude of Health Personnel; D017848:Blood-Borne Pathogens; D002047:Buprenorphine / Q000008:administration & dosage; D003157:Community Pharmacy Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D040261:Harm Reduction; D006801:Humans; D008297:Male; D008691:Methadone / Q000008:administration & dosage; D008875:Middle Aged; D018671:Needle-Exchange Programs / Q000458:organization & administration* / Q000706:statistics & numerical data; D012606:Scotland; D013222:State Medicine; D015819:Substance Abuse, Intravenous / Q000382:microbiology / Q000534:rehabilitation; D011795:Surveys and Questionnaires
D000701:Analgesics, Opioid; D002047:Buprenorphine; D008691:Methadone