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Addiction Services Update

Addiction Services Update. Matthew Dolan Public Health Pharmacist HSCB. Needle Syringe Programme. Currently 14 pharmacies plus Railway Street Anyone can use Confidential First timer receives starter pack Size of kit then depends on whether used needles are returned

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Addiction Services Update

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  1. Addiction Services Update • Matthew Dolan • Public Health Pharmacist • HSCB

  2. Needle Syringe Programme • Currently 14 pharmacies plus Railway Street • Anyone can use • Confidential • First timer receives starter pack • Size of kit then depends on whether used needles are returned • Record made of first 3-4 digits of postcode and equipment supplied • Health promotion materials available

  3. Packs issued vs returns

  4. NSP Forum • NSP Forum meets twice a year • Service providers can use this to raise issues • Attended by pharmacists, CAT, charity organisations, outreach workers • Service user attendance- extremely useful • Issues addressed by PHA / HSCB

  5. Growing issues • Steroid users accessing more frequently- up to 40% of exchanges in some areas • Also used for tanning • Addicts not just injecting heroin- mephedrone now reported, oxycodone • Should supplies be unlimited and/or linked to returns? • Location- rural access or where the population is?

  6. Substitute Prescribing • Replace heroin and other opioids with methadone or buprenorphine • Stabilises misuser’s lifestyle • Reduces crime • More accurately determines level of addiction as now on a known dosage • Reduces risk of blood-borne viruses

  7. Some Numbers Service costs approximately £2.5 million per annum (2011)

  8. Shared Care Guidelines for SP • Patient eligibility • Patient assessment • Criteria for inpatient treatment • Time frames and who to prioritise • Treatment choice • Ongoing review and monitoring • Transfer of care • Community pharmacy guidance

  9. Guidelines and BBV • Ensure patients are offered and receive testing for HIV, Hepatitis A, B and C and receive immunisations against Hepatitis A and B • LFTs if history of BBV exposure • Steer towards maintenance rather than detox initially if BBV status not stable • Recheck BBV status every 6-12 months if patient still participating in risk-taking behaviours

  10. Other workstreams • Database and information • Updated reporting forms including BBV status every 6 months • Reports will be developed and can include BBV • GP Enhanced Service • Directed to check BBV status as part of service • Community Pharmacy • Health Promotion rather than pure supervision • Blood Spot Testing? • Prison service

  11. Other workstreams • DAMIS damis@hscni.net • An early warning service for identifying new substances or emerging trends • Recent alerts, trends and requests for info- include anthrax, oxycodone, synthetic cannabinoids, caffeine • Naloxone Programme • ‘Self’ injector kit now available in NI • Contact local CAT if a patient identified

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