I am sure that I speak for the majority of community pharmacists when I say that recovery is not a new concept from a pharmacy perspective. However, the evolving role that pharmacists play in the field of substance misuse, particularly over the past decade, has seen the development and expansion of services to help people using drugs and alcohol on their recovery journey.
Intuitively, this feels right. The large number of locations and extended opening hours make community pharmacy one of the most accessible healthcare services available, second only to A&E. The pharmacist can be consulted confidentially and without an appointment or without having to register. This high level of flexibility means that pharmacists often see people who do not currently access other substance misuse services, as well as supporting those who are already on their road to recovery.
It has been argued that recovery, for some, starts with the decision to start using clean needles and syringes. As well as significantly reducing the risk of transmission of blood-borne viruses (BBV) such as hepatitis and HIV, this first step will bring the individual in contact with a healthcare professional who can provide general healthcare advice as well as tips to reduce risk. An increasing number of pharmacies are now also offering BBV screening and vaccination services, and this is proving particularly useful for users who are currently unknown to treatment services.
Community pharmacy can signpost people towards a range of treatment and other support, according to where they are on their recovery journey; indeed, in Birmingham where I work, pharmacists can (and do) refer people directly into services. Once in treatment, particularly if prescribing is involved, pharmacists are able to improve the effectiveness of the prescribing, including providing supervised consumption of medication which is responsive to the individual's progress.
It is also worthy of note that the pharmacist will see the service user more than any other healthcare professional and so is often the first to identify people who are slipping back into difficulties. As further support, a number of pharmacies also host regular sessions with local drug workers within the consultation rooms in their pharmacies.
It is not, of course, just about drugs. A significant number of my pharmacist colleagues currently provide a screening and brief intervention service for those people who use alcohol in a harmful or hazardous manner. We also provide a specialist service for those using steroids or other performance and image enhancing drugs. In addition, community pharmacists are able to offer advice (including signposting where appropriate) to those who feel they may have an addiction to prescribed or over-the-counter medicines.
A number of pharmacies also host regular sessions with local drug workers within the consultation rooms in their pharmacies
As well as more pharmacy-based services being developed, pharmacists themselves are finding that their role in the field of substance misuse is evolving. A significant number of pharmacists now prescribe within this field of medicine. As a Consultant Pharmacist, this is the one aspect of my job that I enjoy the most. I currently prescribe at a primary care clinic and also within the prison service. However, I am also responsible for the commissioning and service development of pharmacy-based substance misuse services in over half of the 270 pharmacies across the city. This varied role has enabled me to work with other primary care professionals and service users to design and deliver care, and to work with local specialist treatment providers to provide integrated care.
Community pharmacy is already present at the heart of local communities. Pharmacists not only have a role in supporting recovery in the community, but also in helping people to stay alive and healthy until they are ready to recover.