Article by Fiona Raeburn, Chair, Scottish Specialist Pharmacists in Substance Misuse
This week saw the launch of 2016 data for drug-related deaths in Scotland.
867 deaths have been reported, the highest since data recording began in 1996. The causes of deaths are complex and multi factorial, however, the figures show that drug deaths are more commonly affecting people in an increasingly older age group with multiple significant health problems. As the profession which is generally in contact with patients most regularly, pharmacists are in a unique position to help. Pharmacy teams are key members of the wider integrated team, providing harm reduction and supporting patients in their recovery.
So what can we do?
Most importantly, pharmacies can provide a safe and welcoming environment where people feel supported and encouraged to discuss their progress at whatever stage of recovery they are. A pharmacy team which possesses a good understanding of the challenges faced by people who use drugs and current evidence and treatment options will undoubtedly facilitate this and training such as the NES distance learning pack is available. However, we know from discussion with those people who are accessing pharmacy services the value of a friendly face and empathetic ear regardless of the level of expertise.
The pharmacy team possesses unique knowledge and skills which can be invaluable to clinicians and other member s of the multidisciplinary team. Practical actions which could help improve patient outcomes include:
- 63% of deaths occurred in people classed as “older” drug users of 34 years+. People in this age group often have multiple co-morbidities, diagnosed at an earlier and more advanced stage than peers in the general population. Medicines optimisation is an area where pharmacy excels. Supporting and encouraging patients to take medication as prescribed, encouraging patient attendance and engagement at appointments, assessing whether medicines are prescribed and reviewed appropriately as per current guidance and communicating this to prescribers may all prove critical in maximising patient health, wellbeing and ultimately longevity.
- Participating in the National Naloxone Take Home Programme. Each Scottish Health Board area now has a basic life support and naloxone training and supply programme deliverable as a brief intervention. Pharmacy participation varies across Boards but, where available, allows easy access in the patient’s own community. If your pharmacy does not provide naloxone kits, ensure that the team is aware of local suppliers and able to direct patients and family members to the nearest site.
- Communicating with key workers. There may be clear indicators of concern e.g. where a patient regularly misses doses or attends intoxicated or much more subtle ones e.g. more withdrawn in a discussion, physically unkempt or erratic time of attendance. The wider multi-disciplinary team may be unaware of these vital pieces of information and value such insight.
- Promoting general health of patients and supporting this with services such as minor ailments.
- Being aware of local services supporting people who use drug or alcohol and highlighting these to patients/signposting as appropriate.
The majority of Health Board areas in Scotland have a pharmacist(s) who specialises in substance misuse and can be contacted to provide support and information. If you are unsure of your local specialist pharmacist(s), the current chair, Fiona Raeburn (Grampian), will be happy to put you in contact. You can email Fiona at the following address: Fiona.email@example.com.
You might also be interested in reading our recent article which discusses the role of pharmacists in helping older drug users.