Pharmacy is the ‘logical place’ to provide naloxone kits, says Community Pharmacy Wales

Responding to the Department of Health and Social Care's consultation on improving naloxone access across the UK, Community Pharmacy Wales emphasised the accessibility of community pharmacy.
Naloxone poster in a safe consumption van, Glasgow

In its response to a government consultation on expanding access to naloxone, Community Pharmacy Wales (CPW) said that community pharmacy is the “logical place” to provide naloxone kits.

The Department of Health and Social Care (DHSC)’s consultation, which closed on 28 September 2021, sought views on improving access to naloxone across the four UK nations by widening the range of services that can provide naloxone without a prescription.

Naloxone is used as an emergency antidote for overdoses caused by heroin and other opioids, such as methadone, morphine and fentanyl. Currently, pharmacies across the UK can supply it without a prescription if they also provide drug treatment services, such as opioid substitution. There are also exceptions to the Human Medicines Regulations 2012, which allow for wider provision of naloxone, and a patient group direction can be used to enable supply.

Responding in support of the DHSC proposals, CPW — which represents pharmacy owners in Wales — said there was already a “trusting relationship” between pharmacists and people who inject drugs, because many people use pharmacists to access additional treatments like methadone and/or to collect clean injection equipment.  

CPW also emphasised the accessibility of community pharmacies, who open on weekends and often late at night when other healthcare providers and services, such as GP surgeries, are closed.

The Welsh government’s annual report on substance misuse, ‘Working together to reduce harm: Substance misuse annual report and forward look 2020’, showed that just 21 out of 4,833 take-home naloxone kits supplied in Wales through registered sites between April 2019 and March 2020 were supplied by community pharmacies.

However, in September 2021, a spokesperson for the Welsh government told The Pharmaceutical Journal that it was working with Community Pharmacy Wales “to extend the provision of naloxone within pharmacies that are offering needle and syringe provision”.

In August 2021, the Office for National Statistics reported that drug misuse deaths in Wales in 2020 had decreased by 9.1% between 2019 and 2020, and were at their lowest since 2014 at 51.1 deaths per million.

In Scotland, the Royal Pharmaceutical Society’s policy on ‘Drug deaths and the role of the pharmacy team‘, published in June 2021, called for naloxone to be made available from every community pharmacy.

In July 2021, the Scottish Drug Deaths Taskforce reported that the number of naloxone kits handed out in Scotland increased by “at least” 31% in 2020 compared with the previous year, and that they may have saved almost 1,400 lives in 2020.

Later in July 2021, data from the National Records of Scotland revealed that the number ofdrug-related deaths in Scotland rose to more than 1,300 in 2020 — its highest annual number since records began in 1996.

Meanwhile, in England, in September 2021, a take-home naloxone pilot based in community pharmacies in Somerset and Wakefield reported a supply of more than 330 kits to patients in its first year.

ONS data for 2020 shows that the North East of England had the highest rate of drug misuse-related deaths in England, at 104.6 deaths per million. The lowest rates were seen in London, at 33.1 deaths per million.

Read more: Pharmacists dispensing naloxone without prescription can cut opioid deaths, US study shows

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Citation
The Pharmaceutical Journal, PJ, October 2021, Vol 307, No 7954;307(7954)::DOI:10.1211/PJ.2021.1.110047