F INVENTION
When we did our service user
survey, 70 per cent said they didn’t
want to go back to daily pick-up.
Two or three people said it was the
biggest trigger point for relapse,
because they were constantly in
contact with people who were
carrying illicit Valium or whatever.
People also felt much more in
control of their lives and how
they dealt with dosage – instead
of having to go to a chemist and
drink 120ml of methadone they
could spread that over the day.’
His organisation changed all its
prescribing options, with a lot more
use of buprenorphine, for example.
‘We just gave people options as to
what they were more comfortable
with. In Scotland we turned all our
services into needle exchanges,
because we knew people were
going to struggle with chemists, we
created click-and-collect for needle
exchange, and did a lot of video
prescribing as well.’
TAILORED TO NEED
Not every organisation made
the shift to fortnightly pick-ups,
however, and instead worked to
make sure people were getting a
service tailored to their needs. ‘We
never went to fortnightly,’ says
medical director at WDP, Dr Arun
Dhandayudham.
‘Even before the lockdown we
were already risk-assessing each
patient individually, looking at
all their health risks and pick-up
regimes. We were already well
advanced in our planning, and the
maximum anybody got was one
week – we were also working very
closely with the pharmacies to
establish what kind of resilience
they had in terms of cover. So we
individualised each service user’s
pick-up – some went from daily
supervised to daily unsupervised,
or from once or twice a week to a
maximum of weekly.’
Closer working with
pharmacies also provided a chance
to stay informed about clients who
weren’t coming into services, says
his colleague, operations manager
Vanessa Duke. ‘We’ve been in
pharmacies very regularly dropping
off prescriptions and talking
about clients that they might be
seeing but maybe we haven’t seen.
We’ve also taken in naloxone, safe
storage boxes and leaflets around
public health campaigns like World
Hepatitis Day.’
ONLINE SUPPORT
One of the most significant
changes across the sector has been
the move to online support, which
is not something that everyone
thought would necessarily work. ‘A
really interesting stat among our
service users is that 56 per cent
were able to use online groups
from a standing start, which is
huge,’ says Horne. ‘Everybody
said, “It’ll never work – they just
won’t do it.” But a huge amount of
people have asked if we’ll continue
with the online groups after
lockdown, because they like the
blend of both.’
‘My service has been a skeleton
workforce, but it depends on what
you want to put in – that’s what
you get out of it,’ Barry, a service
user based in Essex, tells DDN.
‘You’ll hear people complain, but
it all depends on the individual
and if you’re determined to get
help. My script’s always there, I can
always message my key worker to
answer my questions or sort out
any problems, and there’s online
support if you need it. It’s down to
your own determination.’
The overwhelming majority of
clients understand completely why
these changes had to be made,
‘We’re getting feedback from
workers as well who are
saying they’ve never had so
much contact with clients’
TONY LEE
stresses Duke. ‘And many of them
have enjoyed the opportunity to
work in a different way. That’s had
some really positive outcomes,
but some have struggled with the
more limited one-to-one contact.
And of course for some clients it’s
been a reduction in face-to-face
contact across multiple services.
Where that’s been the case we’ve
worked with them and identified if
it’s ok to bring them in to service –
where they’ve got complex needs
or are significantly socially isolated,
or if there are particular risks in the
home environment.’
While many clients have
enjoyed the opportunities offered
by online support, it’s been ‘a
mixed picture’, agrees Tony Lee.
‘We have a lot of clients who don’t
have access to the internet – one
of the things we’ve been trying
is giving out phones so at least
we can contact them and have
a conversation. We can have a
conference call and bring them
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SEPTEMBER 2020 • DRINK AND DRUGS NEWS • 13