TREATMENT
‘James’: Last roll of the dice
Above: ‘One of the anxieties we
had was that the individuals
we approached were leading
extremely chaotic lives with
very little structure, and we were
asking them to adopt a very
structured life.’ Clinical lead
Danny Ahmed.
‘It wasn’t about selecting this
cohort and setting up a separate
centre for them, it was about
how can we include these guys in
a programme that has failed to
benefit them historically,’ clinical
lead Danny Ahmed told DDN. ‘We
felt that heroin assisted treatment
and its strong evidence base was a
key way to start work with this difficult to reach group.’ Putting the clinic in
an existing treatment service gave participants the opportunity to engage
with all the partner organisations within the medical practice.
‘One of the anxieties we had was that the individuals we approached
were leading extremely chaotic lives with very little structure, and we were
asking them to adopt a very structured life,’ he said. The team’s worries
were allayed – the attendance rate has been 99 per cent. And because they
were there every day, they have been able to help them with leg ulcers and
other chronic health conditions.
Some of the participants were street homeless when they joined the
programme, but have now had support to get into accommodation. All of
the participants have reported improvement in their own perception of
their health and wellbeing. Ahmed has known some of them for 20 years
while working in substance misuse in
the area and is ‘privileged to see the
progress’ as they physically change.
‘They look brighter, they’ve gained
weight, they’re starting to look really,
really well.’
The cost of the medication is
around £5,000 per person per year,
and PCC Barry Coppinger, who
actively supports and joint-funds
the project with Foundations
Medical Practice, Durham Tees
Valley Community Rehabilitation
Company, Tees and Wear Prisons
Group and South Tees Public Health
‘would love to see the scheme
rolled out to the other boroughs in
Cleveland’.
He compares this cost with
the savings to the taxpayer. ‘The
participants had committed 943
crimes that were detected at a
cost of £3.7m – you can see how
the arguments stack up in support
Patients receiving
two doses a day
at 300mg-400mg
have achieved
stabilisation,
and have been
introduced to
wraparound
services, including
the BBV and
mental health
teams
10 • DRINK AND DRUGS NEWS • MARCH 2020
I never went without drugs since
1999. I spent a lot of time in jail,
but I still used in there as well.
I came into this with a roll of
the dice to see if it does work,
because I’ve tried other things –
all kinds over those two decades.
I thought this can’t hurt, but
I wasn’t really expecting it
to work. But then it was just
unbelievable, how different it is.
I used to shoplift to feed
my habit. Before I started this
programme I needed at least £40
a day to feed my addiction – £40
that I could sell it for, so I’d need
£80 of stock a day. I don’t need
to do that now. I’ve even had a
security guard say to me that
they’ve noticed the difference!
About 9 or 10 o’clock I’d run
to the town, to Boots or one of
the bigger shops for wash stuff or
toiletries. I’d fill up a bag for life
with as much stuff as I could and
get out of that door, no matter
who I had to push out of the way.
Then I was going to sell it,
getting half price of whatever it
cost in the shop. I’d go and get
some more gear to get me over till
the afternoon, then I’d head back
into town again. I’d go somewhere
for a couple of pairs of jeans, then
to House of Fraser or Debenhams
for a few of their Lacoste t-shirts.
I’d go back out and sell them
and that would get me to about
teatime, and about five-ish I’d
head back to town for the last
half hour rush because everyone
wants to get home then. This time
I didn’t care who was there, even if
there were staff, I’d fill up the bag
in front of them and run to that
door. I’d sell that stuff as quick as I
could and that would be my night-
time gear.
You weren’t looking to the
future – you were looking to the
next injection or whatever you
could get. I can see now I’ve got
a future, I can see the direction
I’m heading.
‘I used to shoplift
to feed my habit.
Before I started
this programme I
needed at least £40
a day to feed my
addiction.’
This might not work for
everyone, but it’s worked for me
and for the other people on the
programme. There’s not many
of us on it but it’s the chance
of a lifetime and you can see
the difference in everyone. I
hope other people can have the
chance I’ve been given.
of this scheme,’ he says. ‘So we’re hopeful that we can continue to make
progress, and I’m going to use the proceeds of crime income that I get from
seizing assets from criminals to underwrite the scheme as we go forward.’
The next step is to convince the Home Office (who licensed the project)
and the neighbours – and the neighbours’ neighbours – that the project and
its progress could be expanded beyond Middlesbrough.
‘I continue to be impressed with the overwhelming change in our
participants in such a short timeframe,’ says Ahmed. ‘The majority have
battled addiction for decades and they are finally able to lift their heads out of
the daily struggle of substance use and look forward to living life.’ DDN
This article has been produced with support from Ethypharm, which has
not influenced the content in any way
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