RPS proposes 14 recommendations to mitigate drug-related harms, fatalities

Advocating close collaboration with the Scottish government, the Royal Pharmaceutical Society has recently issued a policy statement outlining 14 recommendations to maintain the ongoing reduction in drug-related deaths. Notably, drug-related fatalities in Scotland hit their lowest point last year since 2017.

Data from the National Records of Scotland revealed 1,051 drug misuse deaths in 2022, marking a decrease of 279 from the preceding year. However, drug-related fatalities in Scotland remain nearly triple the national average for the entire UK.

“Every death from drug misuse is a tragedy for the individual as well as family, friends, and their wider community,” said Laura Wilson, Director of RPS Scotland. “Whilst the number of people dying from drug misuse in Scotland is at its lowest level for five years, the numbers are still far too high. I welcome the initial steps Scottish Government has taken, particularly to expand the availability of naloxone within community pharmacies for emergency use."

The Scottish government has been working with partners to enhance the accessibility of naloxone, a substance capable of swiftly reversing opiate overdoses. This measure includes broader availability through community pharmacies across Scotland, constituting the first recommendation within RPS's policy statement.

"We anticipate collaboration with stakeholders to advance our remaining recommendations, such as granting pharmacists access to patient records for enhanced safety, managing patient transitions between care settings, and introducing safer consumption facilities," Wilson added.

 RPS proposals

With the right backing, pharmacy teams can decrease drug-related harm and improve the well-being of drug users. To achieve this, RPS has presented 14 recommendations and called for coordinated efforts involving the Scottish government, pharmacy organisations, contractors, and teams to implement these measures and prevent drug-related deaths. Notable RPS proposals include:

• Ensure naloxone's availability at all community pharmacies with trained staff for its use.
• Enable all pharmacy teams to address dependence on prescribed or over-the-counter medicines.
• Implement a system in community pharmacy teams to track over-the-counter medication purchases, identifying misuse and preventing it.
• Expand current tools in community pharmacies for new and high-risk medications to include those with dependence risks, promoting education from prescribing to dispensing.
• Utilise community pharmacies as focal points for focused public health campaigns addressing dependence on prescribed, illicit, and over-the-counter medications.
• Grant all pharmacists access to shared patient records and establish clear communication channels with other healthcare professionals involved in the care of drug users.
• Designate specific community pharmacies as hubs where patients can access services from various agencies, primarily targeting patients currently not engaged with services.

Managing risks

Opioids, including heroin and methadone, played a role in 867 (82 per cent) of the 2022 deaths, according to the data. Benzodiazepines like diazepam were associated with 601 deaths, while cocaine contributed to 371 deaths.

Males encounter twice the likelihood of drug-related death compared to females, and the average age of victims rises to 45. However, the decrease in deaths during 2022 was notably more pronounced among males than females, it added.

Individuals residing in the most deprived regions of Scotland face an almost 16-fold higher likelihood of dying from drug misuse in comparison to those in the least deprived areas.

"Drug misuse deaths have experienced a steady rise over the past two decades, with a notably steep surge after 2013," said Julie Ramsay, Head of Demographic Statistics at the National Records of Scotland. "However, the latest statistics reveal the most significant year-on-year decline since the inception of this data series."

Meanwhile, the Scottish government recently sanctioned a six percent increase in the 2023-24 global fund allocation for community pharmacies, totalling £219.5 million. A finalised agreement with Community Pharmacy Scotland establishes a one-year funding package for 2023-24, marking the largest-ever increment for the community pharmacy network.