SUMMARY OF MAIN RECOMMENDATIONS
Development of National and Local Policy
1. The Scottish Executive Health Department and other relevant agencies should ensure that the profession of pharmacy is fully engaged in the development and review of national policies relating to substance misuse.
2. NHS Boards, in conjunction with their local Drug & Alcohol Action Teams ( DAATs) should ensure that the profession of pharmacy is fully engaged in the development of policy and the planning of services through representation at a senior level on every DAAT.
3. NHS Boards and pharmacy contractors should have access to specialist pharmacist advice in relation to formulating and implementing national and local policy on pharmaceutical services for substance misusers.
Services to Substance Misusers
4. The concept of a patient-specific "multi-agency agreement" incorporating a pharmaceutical care plan should be developed for use in NHSScotland and incorporated into all integrated pharmaceutical care services for substance misusers.
5. NHSScotland and other agencies should take advantage of opportunities offered by pharmacist prescribers and the new community pharmacy contract to engage pharmacy more fully in the planning, provision, delivery and extension of services for substance misusers.
6. Pharmacists should adopt a proactive approach to health promotion, health education and harm reduction. Support should be provided to ensure that pharmacists have access to accurate information which is up to date and consistent.
7. NHS Boards should consider building on the success of supervised self-administration of methadone by extending the concept to other treatments and areas of substance misuse.
8. NHS Boards should ensure equitable access to pharmacy services for substance misusers, particularly for the homeless and for ethnic minorities.
Communication
9. National and local networks of pharmacists providing services for substance misusers should be established. These networks should be facilitated by specialist pharmacists in substance misuse.
10. All members of healthcare teams should ensure a regular exchange of information both of a clinical and a "street" nature. This information should reflect local practice and trends.
11. NHSScotland and the Scottish Prison Service ( SPS) should explore arrangements for the integrated and consistent pharmaceutical care of substance misusers.
Education and Training
12. Education and training in substance misuse should be conducted on a multidisciplinary, multi-agency basis. Pharmacists should be afforded every opportunity to attend meetings/seminars in order to develop and promote a team approach to patient care.
13. NHS Boards, with the support of Local Authorities and police services, should organise public education campaigns advocating the benefits to the community of providing pharmacy-based services to substance misusers.
14. Engagement with local communities, especially schools, should be encouraged and facilitated.
Research and Development
15. Pharmacists should be encouraged to engage in research to improve the range of treatments available for substance misuse. They should also be encouraged to engage in multi-disciplinary practice research aimed at increasing the effectiveness of service delivery.
Further Work
16. Consideration should be given to exploring the issues surrounding the misuse of prescribed and purchased medicines.