DDN Magazine July 2023 DDN July_2023 | Page 18


Rough treatment

Introducing a new regular column from Release , Shayla Schlossenberg shares a case study demonstrating the effects of inflexible and ineffective treatment for benzos

Release is the national centre of expertise in drugs and drug laws . We were founded in 1967 – potentially making us the world ’ s oldest drugs charity – and we provide free , non-judgmental , specialist advice and information to the public and professionals on issues related to drug use and drug laws . We also fight for drug policy reform , so that in the future people who use drugs are treated based on principles of human rights , dignity and equality . To achieve this , we advocate for evidence-based drug policies that are founded on principles of public health rather than a criminal justice approach .

We provide frontline services via our legal clinics around the country . We also provide direct advocacy support to people who use drugs , to ensure that those in drug treatment are receiving person-centred care . Over the years , we ’ ve advocated for the rights of many different groups of drug-using people . In some cases , matters are swiftly and positively resolved for all involved – with others , issues can sadly drag on for years at the expense of the service user , who is subjected to inadequate or ill-fitting treatment plans throughout this lengthy process .
Release actively works towards a world where our drugs advocacy service becomes obsolete , and where people who use drugs are
heard when they need changes to their treatment plans – not because they ’ ve brought in ‘ a national expert ’ to sit in on their medical review , but because their needs are respected . To make this vision a reality , we ’ ve embarked upon a mission to create , publish and widely distribute our own advocacy toolkit , so that people can more readily advocate for themselves and their communities .
Of course , our toolkit won ’ t account for everything , and we still find ourselves regularly stumped on advocacy cases . Much of what we ’ ve achieved would not be possible without help from others in the harm reduction world , who have generously shared examples of good practice , specialist resources , and strategy ideas for our advocacy cases . We want to return that kindness by sharing with our community what we have been through and learnt , in the hopes that future services can improve their practices and people can more easily access high quality treatment .
For this reason , every other month , Release will publish a case study in DDN from our advocacy work , including relevant guidelines and pieces of evidence we used . Our aim is to promote better practices for DDN readers who work in services , and to give people tools to challenge their own treatment decisions , if they find themselves in similar circumstances .
Nick ’ s Case
For our first case study , I ’ d like to introduce ‘ Nick ’ – not his real name , but a very much real and recent situation . Nick is a 42-year-old man who was dependent on street benzos , mainly diazepam , when he contacted Release . His benzo supply has not been regular , and when he has accessed drug testing via WEDINOS he has seen that at least on one occasion his supply was bromazolam as opposed to diazepam , which is what it supposedly was when purchased .
Nick has used benzos for six to seven years , on and off for the first few years . He is not sure how long he has been ‘ dependent ’, although he believes this has been since around lockdown . During lockdown , Nick ’ s overall quality of life deteriorated , and his drug use increased . In 2021 , he admitted himself into a private rehab clinic , staying there for two months . He was consulted by a virtual clinician for 20 minutes who was based abroad , then immediately put on only 30mg of diazepam when he was previously on a much higher dose of street benzos . The withdrawal was difficult to manage , impacting his sleep and his ability to take part in psychosocial interventions , causing him eventually to leave the rehab .
Nick has been in drug treatment twice , not counting his time in private rehab . His first time was around 2019 . During lockdown , he returned to drug treatment and has been there since . However , since the end of lockdown , Nick ’ s service has been recommissioned , causing significant staff turnover . Nick was assigned a new key worker every few weeks , negatively impacting his ability to build a therapeutic relationship and make progress in his treatment plan . At this point , Nick reached out to Release , with the goal of safely working towards becoming abstinent from benzos . However , his treatment service says they won ’ t prescribe benzos to him to use for this reduction as it is against the service ’ s policy .
What do the guidelines say about Nick ’ s case ?
Regarding the care Nick received at his private rehab , the Drug misuse and dependence : UK guidelines on clinical management , otherwise known as the Orange Book , states that : ‘ For those who are benzodiazepine dependent ,
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