'Standing Outside the Junkie Door'-service users' experiences of using community pharmacies to access treatment for opioid dependency

Aim: To explore experiences of service users attending a community pharmacy to receive opiate replacement therapy (ORT).

Method: Qualitative study involving seven focus groups undertaken within care centres and prison educational centre in Tayside, Scotland using 41 participants. Thematic analysis undertaken of experiences of different groups of service users and carers.

Results: Participants described the social context surrounding attendance at community pharmacies. Their voices suggested that people prescribed ORT may be treated differently from others accessing care through pharmacies. Participants felt they experienced stigma and discriminatory practices in pharmacies, elsewhere within the healthcare environment, and more generally in society. Participants explained that the way services were organized in pharmacies often denied them the right to confidentiality. However, there were positive experiences of care. The discriminating factor between good and bad experiences was being treated with dignity and respect.

Conclusion: Participants readily identified examples of poor experiences and of stigma and discrimination, yet valued positive relationships with their pharmacy. Constructive attitudes of pharmacy staff and the ability to form positive relationships improved their experience. The social exclusion delivered through stigmatization mitigates against delivery of a recovery agenda and contributes to health inequalities experienced by this marginalized group.