Galway Advertiser 2006/2006_09_14/GA_1409_E1_008.pdf 

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8 N E W S

www.galwayadvertiser.ie

September 14 2006

The HSE is accused of not supporting methadone schemes
BY MARY O'CONNOR A local Irish Pharmaceutical Union spokesperson is accusing the Health Service Executive of not supporting methadone treatment schemes for drug users outside Dublin. Pharmacist and chairperson of the Irish Pharmaceutical Union's Community Pharmacy Committee Darragh O'Loughlin is calling on the health authority to set up a dedicated pharmacy liaison service for pharmacists participating in the scheme, similar to that which is provided in Dublin. Pharmacists could enlist the aid of this service if they encounter difficulties when dispensing methadone to patients, he says. Currently, methadone, a heroin substitute, is prescribed by some local GPs to addicts who are trying to give up drugs. However, a HSE spokesperson says family doctors do not initiate this treatment. " It would be a continuation of treatment commenced at a specialist clinic. There, the client is assessed by a GP specialising in substance misuse and, if appropriate, methadone would be commenced. Once the client is stable the client's own GP could then continue scripting, having completed the training to do so. " There are a significant number of pharmacies in the city and outlying counties taking part in the protocol. They provide a service of dispensing and supervised ingestion." The HSE West also operates a methadone maintenance programme from the Shantalla Clinic. Mr O'Loughlin says community pharmacists dispense methadone to patients who have made a decision to give up heroin. "These people wish to lead normal lives in their communities. The Methadone Treatment Scheme is by and large very successful in the Dublin area. There, patients who wish to overcome a heroin addiction initially attend a methadone clinic to receive methadone. These patients are treated in the clinic until they have detoxified, stabilised and adjusted to the treatment. Once they have stabilised, they are then referred to a community pharmacy, where the methadone is dispensed to them. If a pharmacist in the Dublin area experiences any problems, the pharmacist has the support of the methadone clinic." However, few of these clinics exists outside Dublin, he says. "Therefore when a doctor prescribes methadone to a patient, the patient must often go directly to the community pharmacy to receive it. There is a lack of support from the HSE for the Methadone Treatment Scheme outside Dublin. We are calling on the HSE to set up a dedicated pharmacy liaison service for p h a r m a c i s t s participating in the scheme, similar to that which is being provided in the Dublin area." The current situation must not continue, he insists. "The HSE must appoint a national pharmacy methadone coordinator. Alternatively, local pharmacy contractors should be recruited on a contract basis locally to provide this service, as is the case in Wales." Dr Deirdre NicGearailt, a GP specialising in substance misuse with the HSE West, says she was very encouraged to see that Darragh O'Loughlin perceives a need to treat substance misuse in the west. However, she says he seems to think that a "very limited" service exists which she stresses is not the case. "The drug service of the HSE has a very comprehensive service in this regard. This includes a community methadone programme which has been in operation for a number of years now. There are two clinics based in Shantalla and with the co-operation of GPs in the community and pharmacists we [the HSE] run the service." She says she is "very proud" of the service which is GP-led and believes it rivals any in the country. "We have a team of counsellors and a nurse who liaises between GPs, pharmacists and the clinic and we link into `wraparound' services ie teenage parenting projects, family support, antenatal and psychiatric services. It certainly rivals any services given anywhere in the country. "I think Darragh feels it is a very limited service. This is not the case. It outreaches into outlying counties.We have pharmacists in all counties who co-operate with the service."

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