A cluster of inner-city pharmacies has some McCauley community and business leaders questioning whether some of the roughly 30 shops are taking advantage of Edmonton’s most vulnerable.It’s an issue that has McCauley residents looking to city hall and other regulatory agencies for answers — a count of pharmacies in March 2018 revealed 21 either within or directly on the borders of their community and another nine within two blocks of McCauley’s boundaries.“It comes up in various conversations all the time, and no one seems to have an answer,” McCauley Community League president Greg Lane said in a recent interview. Just north of downtown, McCauley is home to many social agencies and a significant proportion of the city’s affordable housing. For years, some residents and a handful of other core neighbourhoods argued that the concentration of poverty is hurting their communities.The city took steps to ensure that affordable housing will be spread more equitably across Edmonton, but McCauley continues to face other challenges, like the pharmacies that Lane said people suspect of preying on vulnerable people.Lane said that unlike other well-stocked community pharmacies where shoppers can pick up a magazine and some snacks while waiting for their prescriptions, many of the shops in McCauley are quite threadbare.“They’re not really pharmacies in the traditional sense, and I think it’s a fairly innocuous term: pharmacy,” Lane said.Inside Boyle Pharmacy on 97 Street in Chinatown, the non-medical offerings are limited. Shelving on one wall displays chips, a few rolls of paper towels and other basics. Across the store, there’s a small table where light breakfast and coffee is offered to clients. Shelves in front of the pharmacy counter are bare.Pharmacist Vishal Shah says he decided to open the store last October because he wanted to help the neighbourhood’s homeless population.Shah also owns a pharmacy in Oliver, but he said he prefers to work at the Chinatown location because he likes interacting with the clientele. As a pharmacist, he is able to do more regular check-ins with clients than their doctors, and keep a close eye on their health.“There are so many pharmacies, but this area needs them. If there is no need, there is no pharmacy,” he said.Is it necessary?It’s not only nearby residents questioning how many pharmacies the inner-city area needs.“You’d have to suspend disbelief to think that McCauley needs that many pharmacies,” said Ward 6 Coun. Scott McKeen, who represents the neighbourhood.The Chinatown Business Association has called on the city to introduce restrictions on pharmacies and regulate them like liquor stores and impose separation distances. There are no such rules currently and pharmacies operate with general retail licences.McKeen said he thinks the pharmacy industry needs to drive regulation and consider what’s happening in McCauley.But those in the business say there are factors that make McCauley unique.The complex health needs of the vulnerable people drive both a need for pharmacy services and good business opportunities, said pharmacist Cole Mondor.Mondor said when he opened Mint Health and Drugs on Church Street there was community pushback from people unhappy to see yet another pharmacy. He’s worked hard, however, to forge relationships with both vulnerable clients and the wider community.Half of his bright and tidy storefront in the historic Phyllis Grocery building is used as an old-fashioned soda fountain, serving ice cream and coffee. A recent ethnographic research study on services for people experiencing homelessness in Edmonton found that Mondor is one of the local businesses that vulnerable people most often turn to for help.There remains a “severe” lack of front line health-care professionals in the inner city, Mondor said, and pharmacists can help fill that void.Not all pharmacies created equalMondorsaid regulatory changes in recent years have helped crack down on some practices he has seen from competitors that he says are questionable, such as offering cash inducements to encourage vulnerable people to fill their prescriptions at that store.He said vulnerable people often have many prescriptions, and it’s common for there to be a directive that their medications be dispensed on a daily basis.“A lot of individuals have a propensity to have poor compliance with medications, either abusing them or just a lack of insight into how to take them appropriately,” he said.Provincial cuts to pharmacy services in 2018 and other regulatory changes now limit how many daily dispensing fees pharmacists can claim. However, at $12.15 each, multiple daily dispensing fees can net a healthy profit for pharmacies, Mondor said.And though he hoped the Alberta College of Pharmacy’s ban on offering rewards or loyalty programs for pharmacy services would be a “win” to stop pharmacies from offering people cash, he’s heard differently from his clients and other service providers.“It’s become more low key, but it’s still happening,” he said.The Alberta College of Pharmacy confirmed by email Friday that it has temporarily suspended the licence of one community pharmacy in the McCauley area pending the outcome of a hearing, but declined to offer further details.Safe supplyIn the meantime, advocates for people who frequent McCauley pharmacies say it’s a complicated situation.`Boyle Street Community Services spokesman Elliot Tanti said his agency has heard both good and bad stories about their clients’ interactions with the inner-city pharmacies — some are great about engaging, distributing winter clothing and Christmas gifts.“Generally speaking, it’s just like any other downtown business, which leads me to believe it’s quite profitable in the inner city,” Tanti said. Petra Schulz, co-founder of harm reduction advocacy group Moms Stop the Harm, cautioned that any reduction in services could cause more harm by driving people to street drugs.Schulz wrote in an email that the majority of people dying from overdoses in the province have taken contaminated street drugs containing fentanyl or by using fentanyl intentionally.“Taking this source away will drive them into the illicit market, which is too often deadly,” she said. “So any action around any safe supply, always has to consider the demand side and the people who are on these meds.” firstname.lastname@example.org/paigeeparsons
The Boyle Pharmacy at 10608 97 St. in Edmonton. The McCauley Community League is raising questions about the number of inner-city pharmacies.
David Bloom /