Drink and Drugs News DDN November 2019 (1) | Page 11

HOW’S IT GOING? Feedback from the pilot’s participants has shown reasons for optimism. But as always, every case is complex and it’s still early days. This has been a great example of partnership working... It will give service users greater autonomy to focus on other aspects of their lives Dr Arun Dhandayudham quote Professor Sir John Strang’s comments that this could be a ‘game- changer’ in opiate addiction treatment. A further study, published by Neale, Tompkins and Strang in the Harm Reduction Journal (April 2019), supports the idea that these prolonged-release formulations could be beneficial to patients ‘who wanted to avoid thinking about drugs and drug-using associates, wished to evade the stigma of substance use, and desired “normality” and “recovery”.’ Dr Arun Dhandayudham, WDP’s joint CEO and medical director, and Tohel Ahmed, service manager of R3, WDP’s service in Redbridge, had keenly followed the trials in other countries, such as the USA and Australia, and felt that this could help to expand treatment options. Encouraged by the reported success of subcutaneous buprenorphine injections (depots), they established a working group, including WDP staff, Redbridge commissioners and a local pharmacist. Together they developed clinical protocols to enable the new treatment to be prescribed. Beginning with a pilot project in the London borough of Redbridge, they WWW.DRINKANDDRUGSNEWS.COM WHEN NICOLA, AGED 42, joined the trial she felt unsettled on a sublingual dose. Living at home with two daughters, she felt that the depot dose could make life easier and three weeks on she says she feels ‘alright’ and is not tempted to use on top. While she doesn’t miss daily attendance, she has raised issues around support that management are addressing. PAUL, AGED 35, also felt unsettled before the change in treatment, but has felt substantial improvement after a month. He lives with and works with his father and describes the change as ‘brilliant’. SIMON, AGED 29, lives in a shared house and has occasional work. On the new dose for three months, he says he feels better for it. He hasn’t experienced withdrawals but smoked heroin twice when he had been drinking A couple of months on David says he ‘feels fine’ and is glad not to be tied to the pharmacy every day alcohol. He says he feels ‘a better person’ for the change of regime. DAVID, AGED 43, lives in sheltered housing and was struggling before starting the new dose. Initially he was ‘not 100 per cent’, but a couple of months on he says he ‘feels fine’ and is glad not to be tied to the pharmacy every day. Names have been changed to protect identities DDN recruited six service users to try the depot injections. The mixed-sex group of participants includes some who are employed or self-employed, and three of them have children. The staff involved in the pilot have already noticed the benefits for participants in being able to carry on with their lives without being tied to visits to the chemist, with everything that that entails. ‘Stigma is something our service users experience every day, from themselves and others,’ says Dr Della Santhakumar, clinical lead at R3. ‘This option gives a break from it and offers a taste of normality. This can be a very powerful tool psychologically to move forward in their recovery journey.’ The research goes on. WDP’s Innovation and Research Unit is designing a project to evaluate the effectiveness of buprenorphine depots compared to traditional treatment regimens – but in the meantime the success of the pilot is leading to expansion of the programme to more service users, and across other locations. ‘This has been a great example of partnership working,’ says Dr Arun Dhandayudham. ‘It will support good clinical outcomes and give service users greater autonomy to focus on other aspects of their lives.’ DDN This article has been produced with support from an educational grant provided by Camurus, which has not influenced the content in any way. NOVEMBER 2019 • DRINK AND DRUGS NEWS • 11