DECEMBER, Edition # 39, 2001

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Recently, inPHARMation for October 2001 arrived at the pharmacy.
It declares the contents to be about:
"Harm reduction - pharmacy's role."
Helen Kay writes on page 3 that, "we hope you find this special edition interesting and thought provoking".
It was for me.
The first thought provoked was wondering if the apparent interchangeability of illicit and illegal was appropriate.
An on-line English usage site explained the difference this way:

"if something is being done that could be legal, but the way it is being done is not, then illicit is the best word. If the whole process is against the law, then it is illegal."

From this we could deduce that consuming prescription drugs we legally obtained from a pharmacy, but took them in excessive quantities, could be considered to be illicit.
On the other hand, if heroin, cocaine, and various quantities of cannabis in various States are not acquired in conformity with the law, it is therefore an illegal supply and consumption.
The Pharmacy Self Care cards that accompanied the booklet are also thought provoking.
The Methadone card is obviously potentially useful, as is the Drug Overdose card. But the Safer Injecting Practices card is the most thought provoking.
The opening statement:
"Some people use illicit drugs by injecting them. Injecting drugs will always involve many risks, but there are things you can do to reduce some of the risks to yourself and to others."
If the use of the term "illicit" means the card is only directed to those who inject say, Temazepam from capsules, Methadone from takeaway containers, or other drugs legally obtained but used in an illegal way, then the card is okay.
But if the card is intended to be given with packs containing syringes, and it is suspected that the syringes will be used to inject illegal substances, is the pharmacist assisting in an illegal act?
If such assistance is in itself is an illegal act - do pharmacists therefore render themselves liable for prosecution?
This pharmacist believes drug users have enough problems, and anything that can be done to reduce "collateral damage" should be encouraged.
But the missive from PSA has caused me to wonder where we stand with regard to the law.
If we sell syringes without asking what they will be used for, are we in the "ignorance is bliss" situation?
If this is so - if ignorance is bliss - is it folly to be wise?
However, if we hand out either the Drug Overdose, or the Safer injecting practices cards are we aiding and abetting an illegal act, or could this only happen if we have the user acknowledge that the syringes will be used to inject illegal substances?
Finally, I wonder how many other pharmacists who read this magazine feel that the easiest way to control the use of the illegal substances is to make them legal. As a profession we worry about delivering the correct dose, counseling patients on compliance and various other aspects of the legal drug delivery process, including a reluctance by some, to substitute generic drugs for original proprietary drugs. And yet we adopt the principle of virtually condoning the illegal use of drugs, with the somewhat pious attitude that we have at least supplied clean needles, some swabs and some other useful stuff.
An analogy to safe injecting rooms is not teaching people how to ride - bikes, horses, or whatever, but promising to patch them up when they fall off.
Then allowing them to ride and fall, until we can no longer patch them up.....
and they die!.
There seems to be ample evidence that people will indulge in mind changing drug consumption, be it alcohol, antihistamines, cough mixtures, analgesics with codeine and doxylamine succinate, or unlabelled products in foil or plastic bags of unknown strength, purity, or content.
How can we go along with the supply of one group of products without pressing for the right to sell the other?

Editor's Note:
Terry has sent the following links for further reading on the subject:

http://www.tai.org.au/newsletters/nl18heroin.html

http://www.adf.org.au/library/herointri.pdf

To all newsletter subscribers.... have a happy, safe and "non-illicit", "non-illegal" Christmas. Terry Irvine

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