DDN May 2022 May 2022 - Page 22

LETTERS AND COMMENT

‘ As your readers will know only too well a public health emergency is occurring in England . In 2020 , 4,312 people died because of drug related causes , the highest number since records began .’
AMBITIOUS ACTION ON DRUG DEATHS
As your readers will know only too well a public health emergency is occurring in England . In 2020 , 4,312 people died because of drug-related causes , the highest number since records began .
This is a truly intolerable figure , and one that is likely to continue rising without swift and targeted action .
The people we serve often lead lives shaped by stigma and discrimination and face a range of health and social challenges . As treatment and recovery providers we do not have the power to surmount all of these challenges , but we can work to ensure our efforts to reduce drug-related deaths are ambitious , effective and consistent .
That is why we are uniting as senior leaders from third sector and NHS treatment providers at a historic summit in May where we will commit to actions to curb drug-related deaths . The agreed actions will be published as a simple , clear charter embodying our shared intent and pledge . We will also work together to share good practice over the coming year to enable us to enact the actions of the charter .
We would be pleased to provide a more detailed account of the charter in the next issue of DDN . Summit steering group members , Collective Voice and NHS Addictions Provider Alliance
MISSING LINK FOR MENTAL HEALTH
I wanted to share news of how our service users at Aspire have seen their recovery and ongoing abstinence prospects boosted thanks to a pioneering trial with anti-depression therapy .
People needing help for substance misuse problems are often clinically depressed , which impairs their response to drug and alcohol treatment . Through a two-year study at Doncaster ’ s Aspire Drug & Alcohol Services we ’ ve discovered that ‘ behavioural activation therapy ’ could be a key missing link to improving mental health outcomes .
By deliberately practising certain behaviours we can ‘ activate ’ a positive emotional state – so fulfilling activities , such as volunteering or walking , can create a feelgood factor and lead to the addiction being replaced with a healthier alternative .
The study was jointly carried out by staff from Aspire ( a partnership between Rotherham Doncaster and South Humber NHS Foundation Trust ( RDaSH ) and registered charity The Alcohol & Drug Service ), University of
Sheffield academics Sophie Pott , Dr Jaime Delgadillo and Dr Stephen Kellett , along with Professor Stacey Daughters from the University of North Carolina .
For those that took part , behavioural activation was associated with significantly reduced depression at their follow-up 12 weeks later . Participants also used fewer illicit substances on top of their prescribed medication . The researchers told us that this therapy may add clinical benefit to the care provided for patients who have substance misuse and depression problems but that it is an area which needs further research .
The results are very promising , particularly for people who are trying to hold down a job or reduce illicit use on top of their medications . The study has raised exciting prospects for the care provided for this cohort of people across the country , with potential improvements through the talking therapies on offer , as well as returning potential gains on treatment costs and harm reduction .
The findings were published in March 2022 in the highly influential Journal of Substance Abuse Treatment : https :// doi . org / 10.1016 / j . jsat . 2022.108769 Stuart Green , service manager , Aspire Drug & Alcohol Services , Doncaster
CALL FOR CULTURE CHANGE
After reading the DDN update email ( DDN Bitesize , every Tuesday ) I absolutely agree with you regarding the need for a change of culture . I have been working for 20 years + with substance users and no one wakes up in the morning and decides they are going to become an addict . Most of my clients have suffered severe childhood trauma and the only way they can cope with their traumatic memories is by using drugs or alcohol .
There are long waiting lists for the talking therapies and rehab . Most rehab stays are not long enough to deal with the trauma and many talking therapies will not work with someone who is using / drinking . The addict is in a catch-22 situation . There is a shortage of therapies but training to be a therapist is expensive .
We need to train more people who understand substance misuse , mainly those in recovery . People must not suffer more because of the suffering they have already experienced . They have a right to be treated with dignity , respect and compassion – the punishment angle is not the way forward . Liz Abbott , by email
DIAMORPHINE ALTERNATIVE ?
I read with interest your article High Impact ( DDN , April , p22 ) giving Daniel Ahmed ’ s excellent account of heroin assisted treatment and Dr David Bremner ’ s article about the shortage of diamorphine ( p23 ).
In Canada , which outpaces the UK in drug legislation and treatment in my opinion , they have been trialling hydromorphone ( known in the US as Dilaudid ) as an excellent alternative to IV diamorphine .
I can only wonder whether there are the same supply side shortages of hydromorphone – and if not , it could be used as an excellent alternative .
Users in Canada in blind trials couldn ’ t tell the difference as it doesn ’ t produce the unpleasant histamine reaction which IV morphine does . Richard Moore , by email See p16 for our article on diamorphine script restrictions
DDN welcomes all your comments . Please email the editor , claire @ cjwellings . com , join any of the conversations on our Facebook page , or send letters to DDN , CJ Wellings Ltd , Romney House , School Road , Ashford , Kent TN27 0LT . Longer comments and letters may be edited for space or clarity .
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