The Royal Pharmaceutical Society (RPS) in Scotland is calling for naloxone, which blocks the effects of opioids, to be made available in every pharmacy across Scotland, and for all pharmacy staff to be trained in using it.

The recommendation comes as part of RPS’s new policy document, which addresses pharmacy’s role in reducing drug harms and preventing drug deaths in Scotland.

Drug-related deaths in Scotland reached an all-time high last year, with the most recent statistics showing 1,264 people dying in 2019, representing a 6% increase since 2018.

The report outlines 14 recommendations for how pharmacies can better provide effective treatment to people who use drugs and offer harm reduction services.

Naloxone — a medicine that is used to rapidly reverse an opioid overdose — is currently freely available at all pharmacies in Edinburgh that deliver injecting equipment provision services.

As part of its 14 recommendations, RPS is calling for the drug to be available in all pharmacies across the country. This is after a recent study into take-home naloxone programmes found that ownership and carriage of the medicine were ‘lower than desired.’

‘Supplying patients with naloxone and impressing upon them the importance of carrying it is fundamental to the success of the programme,’ RPS said.

The body said that community pharmacies are ‘ideally placed' to make these interventions.

Greater role

RPS also recommended that community pharmacies should be used more to host targeted public health campaigns around a dependence on prescribed, illicit, and over-the-counter medications.

‘Public health is an intrinsic part of pharmacy practice. Pharmacists and pharmacy teams, working in all settings, can support people with a dependence on medicines and/or drugs and prevent dependence from happening by promoting public health messaging,’ said RPS.

‘Teams can educate patients on the importance of adhering to maximum treatment times and dosing, self-management and seeking help with concerns about personal use,’ they added.

The body also stressed that pharmacists should have access to shared patient records as well as clear communication pathways with other healthcare professionals involved in the care of people who use drugs.

Naloxone should be available in every community pharmacy in Scotland, says RPS‘Shared patient records would have a potentially significant impact on drug deaths with the ability to share more quickly, easily, and accurately relevant and potentially lifesaving information with other healthcare providers,’ the body said.

They used the example of patients taking opioid substitution therapy or antiretroviral medication: if the pharmacist has access to patients records it would allow for pharmacists to record missed or refused doses, which in turn would help identify patterns of attendance.

The RPS also suggested that some pharmacies could be turned into primary care public health and holistic care hubs so that patients have better access to services.

‘The availability of community pharmacy situated hubs, and the services they would offer, would be based on local need,’ they explained.

Commenting on the policy document, Laura Wilson, RPS Scotland policy and practice lead, said: ‘It’s concerning that drug related deaths and hospital admissions continue to rise in Scotland. Many of these deaths are preventable.

‘Pharmacists, and pharmacy teams, already play a big role in supporting and providing treatment to people who use drugs, as well as offering harm reduction services and advice. The RPS wants to build on this fantastic work by enabling them to do even more to reduce harm from drugs.

‘We are calling on the Scottish Government, pharmacy organisations, contractors and members of the profession to work together to reduce harm from drugs and improve the health of people who use drugs. We are also asking for significant resource, expertise and finance to be made available’, she said.

‘Scotland needs to take action to reduce its high level of drug deaths, and pharmacy is well placed to play a critical role within this.’ The document comes as The First Minister, Nicola Sturgeon, announced new funding to support the country's national mission to reduce drug related deaths and harms.

The Scottish Government has pledged to invest £50m per year for the next five years - with the target of investing £32m of this to support front-line services in 2021 to 2022.

The Pharmacist has asked the Scottish Government if any of this funding will go to community pharmacies.