Pharmacies as potential providers of harm reduction services: A preliminary online survey

Abstract

Background: Recreational drug use is a major cause of disease, injury, physical and mental impairment and death in developed countries such as the United Kingdom and the United States. Alcohol, tobacco, cannabis, 3,4-methylenedioxymethamphetamine (MDMA) and psilocybe mushrooms are recreational drugs with capacity to cause harm. Cannabis, MDMA and psilocybin have reported therapeutic applications. Objectives: The primary purpose of this study was to determine which of the three types of vendor (pharmacy, shop and the black market) are perceived to be the most suitable for selling the substances discussed according to a general population sample. Methods: A sample of 105 UK nationals was selected for the survey. Participants were presented information regarding reported relative dangers of alcohol, tobacco, cannabis, MDMA and psilocybin and potential therapeutic applications. Participants were then asked to review harm reduction strategies. Results: It was found that participants concluded that pharmacists with available NHS support from GPs and mental health workers are the most suitable vendors of cannabis, MDMA and psilocybin as opposed to regulated shops or the black market (p < 0.001). There was a high level of support for selling cannabis in pharmacies both for therapeutic use and for harm reduction purposes with a mean score of 7.0 out of 10. Participants (60) with a university education were found to be more in favour of the substances being sold primarily in pharmacies (alcohol 5.6, tobacco 6.7, cannabis 7.6, MDMA 6.5 and psilocybin 6.5) than participants (45) with no university qualification (alcohol 5.0, tobacco 4.8, cannabis 6.3, MDMA 5.0 and psilocybin 5.1). Conclusions: The data suggest that the university-educated participants are supportive of treating recreational drug use as a health issue with GPs, mental health workers and pharmacists taking on roles.

Using the pharmacy retail model to examine perceptions and biases of a UK population sample towards regulation of specific psychoactive drugs

“…In a recent study by James et al (2018), a United Kingdom (UK) general population sample of 105 participants determined that pharmacies with available National Health Service (NHS) support from general practitioners (GPs) and mental health workers are more suitable primary vendors of cannabis, 3,4-methylenedioxymethamphetamine (MDMA) and psilocybin than regulated shops or the black market. Participants concluded this after viewing information regarding relative harm and potential therapeutic applications of the substances (see online supplementary material).…”

“…Overestimations by the general population of the harm that the substances discussed pose to the health of the consumer and societal wellbeing may help to perpetuate drug laws which, for example, state that psychedelics such as psilocybin have a high abuse potential (Canal and Murnane, 2017;Elsey, 2017;Sessa, 2015;Thiessen et al, 2018;Walsh et al, 2016). In the study by James et al (2018), questions were asked to participants to assess how closely their perception of the risks associated with the use of specific (recreational) psychoactive drugs corresponds to the reported dangers posed by the substances. It was found that the participants' initial perceptions of relative harm are not in agreement with the relative harm reported in the literature (van Amsterdam et al, 2015).…”

Emerging From the Dark Side: New Therapeutic Applications of Scheduled Psychoactive Substances

“…Remarkably it was estimated that around 22 million people worldwide used ecstasy in 2015, according to the UN World Drug Report [101]. Due to the numbers of users of MDMA worldwide, and comparative safety of pharmaceutical quality MDMA at low doses, there may be a future for MDMA to be sold in a healthcare setting for reducing the harms caused by recreational drugs such as black market ecstasy and new psychoactive substances [6].…”

“…It has been shown that, when members of the public are presented with contemporary information on relative harm and potential therapeutic applications, there is public support for these substances to be available in a healthcare setting particularly amongst the universityeducated section of the population [6]. Public and mainstream scientific perceptions of these substances are shifting and it is not difficult to envision a future in which MDMA and psilocybin play a role in contemporary medicine.…”

“…The recent unintended rise of potent and harmful synthetic cannabinoids such as Spice , particularly amongst the most vulnerable populations, provides one example amongst many of the consequences of ill-informed and reactionary policy making in the U.K. Meanwhile tobacco [103] and alcohol [104] consumption continue unabated in many countries, despite being responsible for more morbidity and mortality than all other illicit products combined [6].…”