Pubdate: Sun, 9 May 1999 Source: Sunday Times (UK) Copyright: 1999 Times Newspapers Ltd. Contact: http://www.sunday-times.co.uk/ Author: Stephen McGinty BAD CHEMISTRY When Christine Glover peers over her tortoiseshell spectacles and speaks of the Incredible Hulk rampaging through her pharmacy, you imagine she has been sipping her own supplies. But she is neither hallucinating nor exaggerating. Glover, a reassuringly matronly woman, ran a quiet pharmacist's on West Maitland Street in the Haymarket area of Edinburgh. It was frequented by young mothers popping in for a packet of Pampers and pensioners collecting prescriptions. But the small store became a battleground when heroin addicts came to collect their supplies of methadone. The anaemic men and women were transformed into roaring "bears" if their "scripts" had been wrongly dated, making them too late to collect. Needless to say, the young mothers and pensioners were increasingly frightened, as was Glover. She decided to sell her practice to Boots and moved to elegant premises on William Street, where she offers personal consultations and homeopathic remedies. Her experience is far from unique. It is the downside of Edinburgh's methadone replacement programme, a programme that drug workers often cite as a model for other cities. Last week the Royal Pharmaceutical Society published the report of a committee, chaired by Glover, that looked at the growing problem. "One girl tried to collect methadone for a friend, which you can't do," remembers Glover. "When our assistant explained why, she went ballistic, F-ing and blinding and threatening my staff. The other customers were terrified and my assistant didn't come back to work for a month. It was the next day the Incredible Hulk came in." Muscled and tattooed, the man was so physically intimidating that staff felt they couldn't cope and he was asked to go elsewhere for his supplies in future. "My husband called later to ask, 'Have your chucked out a man in blue anorak?' He was jumping all over the flower gardens at Haymarket station. I was just glad he wasn't jumping on us." The old world of the local Scottish chemist is long gone. The town pharmacist was once respected as much for dispensing advice as medicine. The most uncomfortable encounter such a professional was likely to experience was a teenager buying condoms. Now pharmacists have the stressful job of servicing Scotland's growing army of drug addicts. Between 1992 and 1996 the number of NHS prescriptions of methadone in Scotland more than doubled from 64,000 to 164,000. Pharmacy inspectors recommend dispensaries limit themselves to a maximum of 10 methadone patients. But in Irvine Welsh's Edinburgh, which has the biggest methadone programme in the country, pharmacists cope with 10 times that figure. Scotland's capital, one of Europe's most graceful cities, has a higher proportion of middle-class housing than almost anywhere else in Britain. But the trouble is not confined to the few deprived housing schemes made famous by Trainspotting. Peter Tinkler is aware of the problems. The owner of an independent pharmacist on the Royal Mile, he enjoys a varied clientele: American and Japanese tourists popping in for camera film and midge repellent, office workers for cough mixtures or headache pills. Then there are his 45 junkies, whose handwritten scripts sit in a tidy bundle at the back of the shop. He says: "A lot of problems come attached. While one is in for his methadone his four mates will try to shoplift you blind. They'll steal anything, even aromatherapy oils." Two incidents stick in his mind. A girl came in to collect not methadone, but an alternative drug they did not have in stock. As he telephoned other dispensaries to find it, the girl's boyfriend began to swear and beat her. "My sales assistant told him to stop slapping her and he went absolutely berserk, then ran out the shop. When the police picked him up they found out he had committed a serious assault on a pensioner just before he came to the shop. We were very lucky." Another enraged addict once threatened to stab all the staff in the shop. "Most you dismiss as bravado - but we believed him," says Tinkler. The Royal Pharmaceutical Society report argued that rules on the dispensing of methadone were hopelessly outdated. The committee collected evidence from a number of Scottish pharmacists who want the regulations reviewed, a point accepted last week by Jack Cunningham, the minister responsible for drugs policy. The strict misuse of drugs regulations were written in 1970 and designed for administering methadone or morphine to terminally ill out-patients, not for daily or weekly doses to heroin addicts. Today drugs such as methadone can only be dispensed exactly as they are worded on the prescription; for example 50ml on a Monday, Wednesday or Friday. "The problem lies with the disorganised life of the user," says Glover. "He may be in jail on a Monday and come to collect on a Tuesday and you can't give it to him. So he gets very mad indeed. You have your staff and the other customers to consider. There is also the terrible amount of time arguing with people which can be better spent." Her arguments are strongly supported by community pharmacists Alison McKinnon and Jim Walker of Walker McKinnon. They have 100 addicts collecting methadone each week from their practice in Edinburgh's Sighthill (the location of the Robert Carlyle television drama Looking After Jo Jo). While composing a time study for the Royal Pharmaceutical Society's report they discovered they spent a full day each week catering to addicts' needs. Both feel the rules more than compound their already-heavy workload. But unlike some fellow professionals, both are happy to do the work. "I feel it is very important to keep them in the community and not pushed out into a ghetto," says Walker. "If that was the case it would be very hard for them to come back into society when their addiction is at an end." McKinnon's believes the recommended figure of 10 per pharamacist is impractical. So, however, are the existing rules by which they are bound. "I feel we do a good job but we if we fix the outdated rules and regulations we could do a better job" she says. Even if the changes are implemented, the sheer scale of addiction is unlikely to lure back the many professionals who have shut up the local shop to work in hospitals or city centre chains. Glover, who charges her new customers A330 a time for a personal consultation, has moved into a different world and doesn't intend to return. "I don't miss the hassle at all," she says. - --- MAP posted-by: Don Beck