Dr Rachel Britton started out as a community pharmacist, but her career has taken a more unique path since – these days she’s more likely to be found at music festivals and pop-up events in university towns, dispensing advice to young people on how to take illegal drugs.
‘I’ve always had an interest in drugs, how they interact with the body and can alter people’s personas and perceptions,’ she says. Dr Britton’s curiosity led her to study a PhD in drug misuse, which looked at the critical role pharmacists can play in caring for people who abuse drugs.
She now works as the director of pharmacy at We Are With You – a charity that offers free and confidential support with drugs, alcohol and mental health – alongside volunteering for the Loop, a not-for-profit community interest company, which provides drug safety testing, welfare and harm reduction services at nightclubs, festivals and other events.
Helping people who misuse drugs is not a new aspect of a pharmacist’s expansive role. At community level, pharmacists often supervise the consumption of methadone and are involved in needle exchange provisions. Hospital pharmacists frequently look after and treat patients who are dependent on illicit drugs.
Dr Britton, however, does something a bit different at the Loop. Alongside a multidisciplinary team of healthcare professionals, she helps advise otherwise healthy – and usually young – individuals on their illicit drug-taking, after their drugs have been tested by chemists, who identify what the drugs are and how strong they might be.
‘After people have their drugs tested, I take them to one side to talk about the results of the drug tests and what other drugs the person is currently taking, their medical history including their mental health – all of which can impact the effects a drug may have on an individual,’ she says.
‘We then talk about ways in which people who do choose to use such drugs – despite our advice that it’s safest not to – may do so while reducing the potential for harm.’
Pharmacists – who have only recently been introduced to the Loop’s healthcare team which consists of a mix of doctors, nurses, psychiatrists and drugs workers – bring with them an abundance of drug expertise to the team of medical experts, including how substances interact with one another to cause unintended and sometimes dangerous side effects.
‘There are some prescription drugs that don’t mix well with illicit drugs,’ Dr Britton explains.
‘For example, if you are taking a prescribed drug such as citalopram for depression, ecstasy or MDMA might be less effective or even ineffective, as the citalopram would limit the MDMA’s effect on the body.
‘If you don’t know this, there is a risk that you take potentially too much and which could ultimately cause death,’ she adds.
Deaths related to illicit drugs have been rising rapidly over the last few years. According to data from NHS Digital, 2,917 deaths by drug misuse were recorded between April 2018 and March 2019 – a 17% increase from 2017 (2,503) and almost 50% higher than 2008 (2,004).
Meanwhile, figures published by the Office of National Statistics today (14 October) show two-thirds (2,883) of 4,393 drug poisoning deaths registered in 2019 were related to drug misuse.
Earlier this month, the BBC reported the deaths of four young people in northern England – including three university students – in suspected drug-related incidents. Police said ketamine and MDMA were suspected to have been a factor in their deaths.
‘It’s so sad to hear that young people are still dying from taking drugs,’ says Dr Britton. ‘I feel like if there was more of this kind of service [the Loop] – more non-judgemental and unbiased advice – we would save more lives.’ Being able to provide that general health advice – without the judgement – is something pharmacists can bring to the table, she adds.
‘The safest way to take an illicit substance is to not take it in the first place. But my training as a pharmacist has always taught me to advise people whether I agree or disagree with their actions – it’s not for me to judge or say what someone does is immoral.
‘The same applies to a pharmacist giving out the morning after pill, your opinion on whether taking the morning after pill is right or wrong doesn’t come into it – you are there to give balanced and evidence-based advice as a healthcare professional.’
‘Care and compassion’
But according to data collected by the Loop, 95% of people who visit the service for drug testing and advice have never sought out, or spoken to, a healthcare professional about their drug taking.
Dr Britton recalls a pop-up event the Loop hosted in Bristol a couple of years ago, where she spoke to students who wanted their drugs tested – and found many of them had never taken illicit drugs before, nor had they had any interaction with a healthcare professional about drugs or how to take them safely, which she says was worrying.
She believes that behind this is the fear that many illicit drug users expected to be treated badly when seeking help, as what they are doing is illegal. But this often means that drug takers don’t go looking for help or advice when they need it, she says, meaning help can arrive too late.
‘If we start to treat these people with care and compassion they will respond to it, and we will be able to help more people in the long run.
‘We as pharmacists – as drug specialists – have a key role to play in keeping these young people, who are coming into contact with illicit drugs for the first time, safe.