Community scheme: Pharmacists participating in the methadone treatment programme for drug addicts are experiencing rising levels of violence, the Irish Pharmaceutical Union (IPU) has warned - methadone is used for treating addiction to heroin and other opiate drugs.
Two of its members were attacked with syringes last week by unstable methadone patients, the IPU said. The body, which represents pharmacists, said the addicts were not suitable for treatment in the community.
Pharmacists and their staff have also experienced gun attacks and other violent behaviour over the past year. According to the latest figures, 6,886 people addicted to heroin and morphine are receiving treatment under the methadone programme in the Republic. Some 286 community pharmacists and 204 GPs participate in the programme. However, pharmacists say the methadone treatment protocol has become unworkable because of a growing trend for health boards to refer unstabilised patients to community pharmacies.
While many patients on long-term methadone therapy are stable, those who are beginning treatment or who have a separate psychiatric problem can be unstable, leading to aggressive and violent behaviour.
Under the terms of the protocol which pharmacists signed up to, if a patient destabilises while on methadone treatment, he or she should be removed from the local pharmacists' list. The 1998 protocol also states "more difficult patients... will not be dispensed methadone by community pharmacists but will be treated at a central level".
Despite the IPU highlighting the problem with the Department of Health early this year, a number of meetings to discuss the issue had been cancelled, the IPU said. The latest date for a meeting between the two sides is scheduled for today. "There is an enormous feeling of frustration. Our staff and ourselves feel in constant danger from unstabilised methadone patients," a north Dublin pharmacist told The Irish Times yesterday.
Last week, a report by Dr Paul Quigley of the HIV and Addiction Service in Dublin found that both staff and clients are running a high risk of violent episodes in methadone clinics. The three-year study of five city clinics and 17,000 consultations found staff came into dispute with clients over prescriptions, takeaway doses and allegations of drug dealing on pharmacy premises. The report also found a problem with patients being in a disturbed state as they come down from illegal drugs.
A separate study has found opiate use in the seven health board areas outside the greater Dublin area quadrupled between 1998 and 2002. There are no State methadone clinics outside of the Eastern Regional Health Authority and all methadone patients must be dealt with in a community pharmacy setting.
A Department of Health spokeswoman said it valued the role of community pharmacists in providing a methadone service. "Discussions are ongoing and are focusing in particular on the co-ordination arrangements that are already in place," she said.