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
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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