Looking after people on medication-assisted treatment during the coronavirus pandemic

27 March 2020

Statement from Mark Moody, CEO 

I'd like to take this opportunity to explain the decisions we have taken in relation to Medication Assisted Treatment (MAT).

Change Grow Live’s services look after some of the most vulnerable people in society, including more than 30,000 people who rely on us to help them manage and reduce their dependency on heroin and other street drugs.

Last week, with pharmacies under increasing pressure and more stringent social distancing measures coming into force, it became clear that we could no longer support people on medication-assisted treatment (MAT) using our tried and tested approach.

It was not going to be possible for most people on a daily regime to keep collecting their prescriptions or for pharmacies to keep delivering the vital supervision services that help keep people safe.

We were faced with a stark choice: have thousands of people on a daily regime to find their own solutions to an erratic and unpredictable supply of prescription drugs, or move to a new way of doing things.

After consulting widely and balancing the risks and benefits of various scenarios, we took the decision to move to a new regime offering people up to two weeks supply of medication because:

  • Without medication, people are more likely to use street opioids and this would put them at greater risk of harm
  • It’s almost always safer for someone who needs medication to have it available to take home rather than leaving them with nothing at all
  • People on medication-assisted treatment (MAT) are likely to be at significantly greater risk of complications from coronavirus, and have already been advised to avoid all unnecessary social contact.

Dr Prun Bijral, Executive Medical Director, explains the rationale behind this new approach in more detail:

This new approach balances the requirement to continue providing those on medication-assisted treatment with the drugs they need whilst contributing to the national effort to reduce the spread of Coronavirus.

The consequences of catching Coronavirus are more serious for many of our service users because of their compromised health status and the particularly high prevalence of respiratory disease within this group. Asking them to attend a pharmacy once every 2 weeks, instead of once a day, greatly reduces their exposure to the risk of infection.

Additionally, stopping daily supervised consumption also greatly reduces contact with pharmacy staff, reducing the risk of infection amongst this critical group of health professionals at a time when families and communities need them the most.

Our overarching advice is to stop daily prescribing, but it's important to note that whilst we plan to move the majority of people on medication-assisted treatment to a 2 weekly pick up, there are exceptions to this based on specific risk factors, for example, those living in hostels, night shelters, or rough sleepers.

We are also taking a range of actions to mitigate any risks associated with 2 weekly supplies by providing people with locked boxes, naloxone and regular telephone contact.  We are monitoring this situation on a daily basis and will adjust our approach if the data indicates there are increased overdoses, drug related deaths or other serious unintended consequences.

We fully recognise that this is not a perfect solution and that there are risks involved. We’re doing everything we can to make sure that people on medication-assisted treatment programmes, their families and communities are kept safe and well.