The Royal Pharmaceutical Society (RPS) has responded to a charity’s suggestion that specialist pharmacies should be the ‘main outlet’ for sales of cocaine and MDMA, stating that the role of a pharmacist is ‘completely incompatible’ with supplying illicit substances.
Transform, a drug policy reform charity made the proposal in How to regulate stimulants: A practical guide, a book published earlier this month.
The book argues that ‘a system modelled on pharmacy provision could provide an effective way of managing the availability of some drugs for non-medical use’.
In response to the suggestion, Gino Martini, chief scientist at the RPS, said: ‘The role of a pharmacist is to improve health, which is completely incompatible with selling these and any other substances for recreational use which we know causes harm without any health benefit.’
James Nicholls, Transform’s chief executive officer, said the charity was ‘grateful for feedback from pharmacists and hoped to ‘continue the conversation with the pharmacist community’.
‘Strictly controlled retail model’
The book acknowledged that its suggested approach has raised questions for pharmacists – ‘some of whom are unhappy moving outside of their established medical dispensing role into non-medical use of drugs’ – but said a specialist non-medical drug pharmacist model could help to address some of these concerns.
‘This new professional specialism would be subject to similar training and codes of practice as conventional pharmacists but with additional access control criteria, responsibilities, specialist knowledge and qualifications,’ the book said.
It added that licensed and trained health professionals would ‘serve as gatekeepers’ in this ‘strictly controlled retail model’ and would enforce restrictions on ‘age, intoxication and amount purchased’.
‘Crucially they would also be trained to offer advice on risk, safer use, and access to services where needed,’ it said.
Mr Nicholls added: ‘We recognise that our proposed model moves beyond conventional pharmacist roles, and the challenges this poses. Importantly, outlets modelled on pharmacies would not be identical – so the issue is, primarily, how best practice can be transferred.
‘The hard reality, though, is that these substances are going to be sold somewhere. At the moment, it is on the street or through the dark web. As a result, we have far too many people dying, entering the criminal justice system, and suffering violence and exploitation. We believe that, given the options, a pharmacist model provides the safest alternative.
‘We hope to continue our conversation with the pharmacist community to improve our proposals, as we work to end the catastrophes caused by an unregulated drug market.’
Rachel Britton, director of pharmacy at the We Are With You drugs charity, told the Pharmacist that Transform’s guide made for ‘compelling reading’.
‘It is clear that current drug policy is not protecting users of drugs such as cocaine and MDMA from harm and this guide provides a lens into an alternative to continued prohibition,’ she said.
‘Making such drugs available from pharmacies means that the user is in contact with a healthcare professional who can provide evidence based and non-judgemental advice on these substances, which will reduce the harms associated with their use.
She added: ‘Clearly, pharmacists who might be involved in supply in this way will need specialist training and a route to refer those, should their use become problematic.’
Meanwhile, Mike Hewitson, superintendent pharmacist at Beaminster Pharmacy in Dorset, said he thought that drugs should be treated as a healthcare issue, rather than a criminal one.
‘We [the UK] should be prepared to do something different when it comes to drugs, how we are currently handling them is not working,’ he said.
Mr Hewsitson supported the Transform charity’s proposal that pharmacists could be used to distribute drugs to users, but disagreed with its suggestion that specialist pharmacies with specially-trained staff should be commissioned to do the work.
He added: ‘To recreate a whole other infrastructure right now feels counterintuitive. I think pharmacists and pharmacies as they are could provide a service, as long as pharmacies meet a rigorous set of quality standards and pharmacies receive really strong additional training.
‘I don’t think it would be for everyone, I’m sure many pharmacists wouldn’t feel comfortable providing such a service. But I think in areas which have been hit hard by drug deaths, pharmacies would be prepared to do something different if they thought it was going to keep people safe.’