Pharmacy has become the central for delivering the substitute medicine for opioid dependence. Methadone and buprenorphine are the approved drugs used for the treatment of withdrawal symptoms. This is an important service provided by pharmacies to target misuse of illicit substances and prevent withdrawal symptoms and reduce risk to the patient. Before deciding to prescribe, a full assessment of the patient will be undertaken by the clinician and a care plan will be put in place and agreed with the patient and they will be assigned to a pharmacy.
The person supervising the consumption is normally the pharmacist who is competent. At induction there is a risk for over dose and the aim is to achieve an optimal dose for the patient. The pharmacy team will protect the patients confidentially and provide support in any way they can. Supervised consumption usually lasts for approximately three months although it can vary depending on the patient’s compliance level. The patient will have to attend the pharmacy to collect their dose, how often they will have to do this will depend on the the level of supervision required. If the patient misses three or more doses, they will be referred back to the prescriber before the next dose. A review needs to be performed as they will have lost their tolerance and will be at a risk of overdose. Therefore a new titration may need to be started. The need for supervised consumption will be reviewed on a regular basis. If treatment failure is identified, supervised consumption will be re-introduced.