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Treating patients with addiction problems with respect

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The Respect Rx Pharmasave in Ottawa is not your ordinary community pharmacy. You won’t find a cosmetics section, home staples or many of the regular categories and products you’d find in many drugstores. There are small confection, OTC, vitamin and pain medication offerings, but the front shop is all behind the counter.

By Talbot Boggs

Photography by Ben Welland

This pharmacy’s business comes almost entirely from the dispensary, and a large portion of its customers are not mothers looking to buy formula and diapers, but recovering opiate addicts who come for tests and daily methadone treatments.

Respect RX Pharmasave was set up by a group of four Ottawa pharmacists who wanted to change the way people addicted to opiates are treated. Head pharmacist Don Johnstone first became involved in addiction treatment about five years ago when he joined the Westboro Pharmasave in another area of Ottawa which had some methadone patients.

“That part of the practice just seemed to grow over time,” Johnstone says. “When we looked around it was quite obvious that other pharmacies were doing a less than admirable job in the way they treated and helped these patients. A lot of stores and clinics that deal with addiction treat their patients as second-class citizens. Often they have to enter the pharmacy by a side door. We wanted to create a nice atmosphere where these patients would feel welcome and proud to be getting treatment.”

Johnstone and his partners began conversations with Dr. Mark Ujjainwalla, founder of the Recovery Ottawa Clinic, and other doctors, and ultimately invested about $800,000 to build and open the pharmacy and clinic last October. The entire 6,500 sq. ft. facility includes four doctors’ offices, four examination rooms, four washrooms, a boardroom, laboratory, reception and three flexible areas which can be used for a variety of purposes. Recovery Ottawa is a walk-in clinic. Appointments are not required.

“In most places there’s a waiting list of one to two months before patients can start receiving treatments,” Johnstone says. “If they get turned away they likely may never come back and get the treatment they need. But here they can walk right in, see a doctor, have their urine tested for opiates and start their treatments right away. It’s extremely patient-friendly.”

Patients normally come to the pharmacy every day for their treatments until they have had 2 months of clean urine samples, after which time they can start to get doses to take home with them. If patients continue to do well they will eventually only need to come to the pharmacy once a week for an observed dose.

Technology is centre stage

The pharmacy is equipped with the latest technology in addiction treatment and features MethaMeasure, a highly advanced computerized methadone system. Patients arrive in the pharmacy and are identified using a picture and fingerprint. The dispenser is prompted with the correct dose for that day, the dose is dispensed by a pump, and the controlled drug register is automatically updated. A patient receiving one in-store dose and six carry-home doses can be processed in less than one minute.

Recovery Ottawa is treating between 500 and 700 addiction patients but has the capacity to increase that number to as many as 2,000. The pharmacy processes about 1,500 prescriptions a week, and about 80 per cent of its customer base is from the clinic, but Johnstone hopes to increase the non-clinic side of the business over time as the pharmacy becomes better known in the area.

“As we get established, we hope to start supplying and working with group homes in the area and generally increase the non-clinic side of the business,” Johnstone says. “Our focus may be highly specialized, but it is very rewarding to see how we can help these people with their addiction issues and to see them start to feel good about themselves again.”