Trays and Methadone

Salam warahmatullah.
Today is Sunday, 31st of August. Happy 51st Independence Day, Malaysia!..and Farewell Sha'ban, Ahlan Wasahlan ya Ramadhan!May this Ramadhan sharpen the saw which will continue to work even after Ramadhan, Aamin.
Tomorrow is Monday, 1st of July. 1st of Ramadhan. and first day of not working after 8 weeks of being full time worker at Cohens Chemist. Faster than an eye blink, that's how time flies.
Before hand, let me update on 2 things that I've promised to you readers in the previous entries - Substance Dependency Module ( SDM ) and Monitored Dosage System ( MDS ).

Substance Dependency Module.
As what the name suggests, this module is devised for those who are dependent, or to make it clearer, addicted to a certain drug. There are many drug addicts out there, who wish to stop, to start a better life, but using willpower alone is not enough. Without helps from professionals, quitting would lead to pains - the pain to resist the temptations, and the pain to encounter the withdrawal symptoms - Muscle tremors, etc. That's why, here in the UK, most towns will have their own Community Drug Clinics, eg in Manchester and Stockport, where I worked. Those who wish to stop abusing drugs are encouraged to visit the clinics, for consultations with trained doctors. To help these patients to overcome their withdrawal symptoms, doctors would normally prescribe two types of controlled drugs - Diazepam ( Usually 5 & 10 mg ), and Methadone 1 mg/ml liquid ( Sugar Free or non Sugar Free mixture ). These patients will then take the prescriptions to the local chemist to get the medicines dispensed. And they need to come themselves to pick the medicines. If they are unable to come by themselves, they need to provide a short letter, stating the name of the name of person who come for them. And these letters are to be kept by the chemist, as a record.
These drug clinic patients would normally get a prescription for two weeks supply. So, if they need to take 4 Diazepam 5 mg tablets everyday, over the course of 14 days, they should be supplied with ( 4 x 14 = 56 tablets ). However, to prevent abuse, they are not given 2 weeks supply as a whole, they need to come and take their medicines EVERYDAY ( Excluding days which the chemist is closed such as Sunday and Bank Holiday ).If they don't come on the a particular day and turn up the next day, they will not get the supply for the previous day, they MUST COME on the days which they are instructed to, otherwise they'll miss their medications.
Likewise, the medicines prescribed for them are carefully chosen based on level of addiction. If a new patient require methadone, doctors would normally prescribe NON SUGAR-FREE METHADONE liquid, which they should take orally, and warn them on potential dangers of abuse. If they inject this liquid straight into bloodstream, they'd die because of the sugar. Afterwards, over time, the patients would be assessed on their addiction levels, if they are getting better, doctors might put them under SUGAR FREE METHADONE ( A new patient is not prescribed with this liquid to prevent them injecting to obtain a faster effect ).Throughout the course, if the patients follow the instructions and advices correctly, they might not need to come everyday, and even stop completely. That's how it works. You can't force a drug addicts to stop in one go, it's too painful, they really need professional consultations. That's where you need empathy, doctors!..
However, some people might not be satisfied with this service, not because it's inefficient, but because it uses NHS fund. Most of these patients come from low-income family, get Income Supports, get Income-Based JobSeeker Allowance, which exempt them from paying for their medicines. And these Controlled Drugs ( CD's ) are expensive. This means, taxpayers pay for these patients' medicines, which some would think unfair - working all day, struggling to pay for all kind of mortgages and insurances, and on the other side of community, some drug abusers are enjoying their medications for FREE. Aperkah???..
But, thinking it deeply, if the taxpayers don't help these patients, they might ruin others' lives with all kind of crimes, these scare people. And if these drugs addicts recover, they'd contribute to the community in all possible ways. And, we'd never know, if one day, our own children, close friends need this service..
Pros and Cons, nothing is perfect, we just need to minimize the risks.

Monitored Dosage System ( MDS ).
Everyone in the chemist, and even the patients, refer this system as `Tray (s)'. As the name suggests, tablets are placed in trays according to the time which the patients are suppose to take them. Interesting, but very tedious to prepare, need to be extra Careful.

An example of a tray. Picture taken from :
http://medicinesincareexpert.files.wordpress.com/2008/03/j0390523.jpg

This service is given for FREE for elderly patients who fall under Disability Act - such as poor vision, unable to hold their tablets properly. Those who are not entitled to this act but having problems with their medicines intake can also use this service, but with a payment of 3 GBP per week, which is not bad at all.
There are four times which patients would take their medicines - Breakfast, Afternoon, Evening, and Bedtime. The dispensers would pop out the tablets from blister packs or pour the loose tablets from their container, and place them in the correct spaces with the correct quantity. Descriptions of each tablet's appearance ( eg colous, shape, markings, scorings ) must be noted clearly and correctly. The pharmacist will the check these trays ( which means, going through each small space ) to ensure that correct tablets are dispensed. It's just SO TEDIOUS, take so long time.
I did try to prepare a tray, ONCE. Jose the supervisor would normally prepare this, but one day she showed me from the start on doing trays and let me prepare for one patient. Thanks Allah, I prepared the tablets correctly upon being checked by Sarah, the pharmacist. But, preparing the trays just make me sick - sick of thinking how miserable life would be if we don't take extra precautions with our health and lifestyles when we are still young. Imagine, for the patients whom I prepared his trays, I guess he has at least high blood pressure and diabetic.And with the conditions ( and other conditions that I don't know ), he takes about 9-10 tablets during breakfast, 4 tablets in the afternoon, and 5-6 tablets before bed.Argh, I'm sick seeing those tablets, I don't want to take so much when I get older. Maka, jagalah kesihatan, supaya tak perlu makan tablet banyak-banyak bila tua. ( Tu pun kalau sampai umur tua ).

Tomorrow is Monday. 1st of September.1st day of Ramadhan. 1st day of not working.With some scripts left untouched on Friday 29th Aug, I shall miss those yellow,white, and red baskets.

Anyway, Ahlan Ya Ramadhan! Mari mengejar pahala sebanyak-banyaknya.

Thank you. Full Stop. Wassalam.

p/s : I really need to go somewhere outside Manchester before the school starts. Any suggestion?