Continuation of conflicts over methadone / prescription of an unrelated deputy for the distribution of narcotic drugs!

Fars News Agency – Health Group: In the early 1980s, after the establishment of addiction treatment centers in the country, addiction treatment drugs were distributed by these centers among the addicts undergoing treatment, but since two years ago, pharmacies insisted that methadone is also a kind of drug and its distribution location should be in be a pharmacy, while the national center of trade associations of outpatient addiction treatment centers of the country emphasized that based on addiction treatment protocols, addiction treatment drugs should be taken under the supervision of addiction therapists.

A group considered it wrong to distribute methadone in places other than addiction treatment centers, and in contrast to another group, they emphasized that methadone, as a type of medicine, should be distributed in pharmacies. Each of these two groups has its own argument and so far none of them have been able to accept their arguments to the other. It’s been a few days now that after the judicial follow-up of the Center of Addiction Therapists, the hand of pharmacies has been reduced from the distribution of therapeutic narcotics and the legal supply of methadone is the responsibility of private addiction treatment centers (clinics).

Saeed Karimi, deputy director of treatment at the Ministry of Health, stated that there are about 8,000 addiction treatment centers in the country and said: These centers have been working for 20 years and there has not been much change in them. Accordingly, according to the decisions of the National Anti-Narcotics Headquarters, the Ministry of Health had the duty to review all the instructions of these centers, which was done through two instructions, one for the centers and one about the treatment and new methods of treatment. It was brought up in the vice-president of treatment of the anti-narcotics headquarters and related measures have been taken. After reviewing and collecting the opinions of all members, it will be notified and finalized through the anti-narcotics headquarters.

He stated that the guidelines for new methods of addiction treatment are 80 pages long and many new methods have been proposed, adding that the tariffs for these new methods of addiction treatment have been almost determined. At the same time, it has been announced what the characteristics of the centers should be, which will be announced after the finalization.

Regarding the distribution of methadone in addiction treatment centers, Karimi said: Currently, the decision of the anti-narcotics headquarters is to give methadone to addiction treatment centers and not to pharmacies. Because methadone is not a drug that people can easily get from a pharmacy. There should be a place where they are prescribed and consumed under the supervision of a doctor. Currently, according to the opinion of the anti-narcotics headquarters, methadone addiction treatment centers are delivered and prescribed and consumed under the supervision of a doctor. Of course, it is not necessarily like this in the world and it is distributed in pharmacies under certain conditions.

Distribution of methadone in pharmacies or addiction treatment centers?

Regarding the measures taken to prevent the leakage of methadone from addiction treatment centers, he said: By the way, new measures have been taken in this field; So that the prescription of methadone should be done in an electronic system and registered with a national code that shows who was given the drug and how much it was. Previously, the system that existed in this field did not have many reporting and dashboard capabilities. Now, in the new electronic system that will be announced soon, we are moving towards transparency, and it is completely traceable as to how much medicine and methadone was prescribed for whom, and whether a person’s consumption gradually decreased or increased, and how many patients they had, etc. Everything becomes clear.

The instruction is illegal and unenforceable

These statements of the Deputy Director of the Ministry of Health met with the reaction of the Pharmacists Association, and the Vice President of the Iranian Pharmacists Association, referring to the new instructions of the Deputy Director of the Ministry of Health regarding the non-distribution of addiction treatment drugs in pharmacies, said: “On behalf of the Iranian Pharmacists Association, to the Minister of Health. We wrote a letter and noted that this instruction is illegal and unenforceable.

He added: According to all existing laws, including the main law, which is the Law on the Regulation of Medical and Pharmaceutical Affairs approved in 1344, no place other than a pharmacy has been introduced to supply drugs. In addition, according to Clause (f) of Article 196 of the Law of the Third Development Program approved in 1379, it is prohibited to supply medicine to the final consumer outside the pharmacy.

Fatemi continued: The story started from here when in the meeting number 136 of the anti-narcotics headquarters in August 2018, it was decided to distribute the agonist drugs for addiction treatment through pharmacies instead of addiction treatment centers. Based on this, in 2019, the Food and Drug Organization wrote the regulations for the distribution and supply of controlled drugs in pharmacies and defined the qualified pharmacies for the distribution and supply of controlled drugs.

Fatemi said: Following these two actions, the National Association of Trade Unions of Drug Abuse Treatment Centers filed a complaint with the Anti-Narcotics Headquarters and the Food and Drug Organization to the Court of Administrative Justice, but the General Board of the Court rejected this complaint on August 12, 1400. rejected and did not consider these approvals revocable. Based on this, the instruction of the vice-chancellor of treatment that drugs for addiction treatment are not given to pharmacies is illegal and according to the previous ruling of the Administrative Court of Justice in this case, it can be easily overturned in the courts.

Fatemi stated that we have not yet received this instruction and said: But we wrote a letter to the Minister of Health on behalf of the Iranian Pharmacists Association and noted that this instruction is illegal and cannot be implemented.

The vice president of the Iranian Pharmacists Association emphasized: Currently, there are two regulations under the title “Regulations for the distribution and supply of controlled drugs in pharmacies approved in 2019” and “Instructions for determining the qualified pharmacies for the distribution and supply of controlled drugs approved in 1400” by the Food and The drug has been announced, in which three places have been considered for the supply of controlled drugs, which include addiction treatment centers, hospital pharmacies and selected qualified pharmacies.

Fatemi said: According to these rules, the drug treatment centers can still supply these drugs, but they should write a directive in an unrelated deputy of the Ministry of Health that pharmacies, which are the main place of supply of all drugs in the world, are not allowed to sell some drugs. It is surprising.

According to Fars report, there has always been a suspicion that there is trade interest involved in the issue of opposition to handing over narcotic drugs to pharmacies or addiction treatment centers. Leakage of methadone is another concern that before, decision makers thought that by leaving methadone to special pharmacies and strict supervision, there is no possibility of leakage anymore. Now, with the new decision of the Ministry of Health, we have to see what will happen to the distribution of methadone and will not the distribution of this drug in addiction treatment centers lead to the leakage of this drug?

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