NHS Dumfries & Galloway

Region’s drug treatment programme noted in national report

CHALLENGES are still being faced in the bid to reduce the region’s drug-related deaths – but with a new treatment fuelling hopes that progress can be made.

Dumfries and Galloway’s successful introduction of a new medication to help treat opioid dependence has attracted national interest and raised local hopes of improved outcomes – after successive high rates of drug-related deaths.

Consultant in Public Health Medicine Dr Andrew Carnon said: “Drug deaths are preventable, but sadly it’s unlikely that there will ever be one simple, easy means to address this issue either in Dumfries and Galloway or nationally.

“However, amid all the work that takes place within this area, the success we’ve been seeing with the medicine Buvidal™ over recent months does offer further hope – by offering a greater choice to people seeking help.”

A pilot programme launched within Dumfries and Galloway in December 2020 has now been highlighted in a national report, after it quickly expanded from an initial 30 people to 210.

Dr Carnon said: “This medication is used to treat dependence on opioid (narcotic) drugs such as heroin or morphine.

“An advantage of this medication is that it is injected under the skin and that it is long-lasting. As a result, it does not need to be taken daily – instead it is provided weekly or monthly.

“This means that those people using this medication are supported to live more settled lives, with less disruption to responsibilities like work or important social connections.

“We’re hoping that it’s going to make a significant difference.”

A national report on the implementation of medication assisted treatment (MAT) standards for 2022/23 was published in June this year, and showed Dumfries and Galloway making good progress in the aim to achieve ten national goals.

Highlighting the use of Buvidal™ (or long-acting injectable buprenorphine) as part of MAT Standard 2 which is focused on choice, the report said: “There are good examples of work to overcome challenges.

“In NHS Dumfries and Galloway, the service has built multidisciplinary teams, including roles such as support workers and a clinical psychiatrist alongside nurses, pharmacy technicians and pharmacists.

“Investing in staff training can help people make informed choices as it enables staff to provide clear and up-to-date information. Since the launch of the pilot in December 2020, continuous growth and investment has enabled the service to expand the number of patients they can treat with buprenorphine from 30 to 210 people.”

Continuing to focus on Dumfries and Galloway, the report added: “In line with MAT standard 2, buprenorphine is offered as a first line treatment for new assessments if suitable.

“Increasing the medication options available to people to include buprenorphine has had considerable impact on service users. They are given more choice in treatment and enabled to make informed decisions.”

The report notes that the region has two main hubs with 55 NHS Specialist Drug and Alcohol Service staff members in multidisciplinary teams. The service works closely with Third Sector partners including We Are With You and Alcohol and Drug Support Southwest Scotland. There is also good collaboration with community pharmacies and GP practices in the region.

Additionally, it recognises the structured approaches within Scotland to overcome the challenges of rurality and maximise access choice and care through technology, travel and models of care – pointing to actions like high use of self-referral and telephone, ‘tele-health’ technology such as NEAR ME, wide use of bus passes, taxis, and third sector to take people to appointments, and offering a choice of venues to be seen at such as GP practice, home, community hubs.

It also says, ‘There has been an increased use of non-statutory services and peers to engage and support people, thus freeing up capacity to deliver rapid access and ensuring that staff can work at highest level within their banding.’

Despite the recognition of all the work which is taking place, and wider work such as provision and promotion of naloxone kits which can help reverse the effects of an overdose, Dr Carnon is cautious.

Noting that the last annual report on drug-related deaths saw a total of 35 lives lost in 2021, Dr Carnon said: “If we’re going to help people, and prevent avoidable deaths, it’s not going to be a simple, overnight solution.

“A great deal of work is already taking place, but more needs to be done to help prevent these deaths, where each one represents loss of a loved one, leaving behind a grieving family, friends and members of the community.
“Hopefully, we can build on this progress, and that, given time, programmes offering people greater choice might start to lead to better outcomes.”

Further information on other websites and local drug and alcohol services that can help, along with other more detailed guidance, can be found at www.stopdgdrugdeaths.co.uk