Responding to the challenge of reducing drug-related deaths
As drug-related deaths continue to rise it has never been more important for treatment providers to deliver services that help keep people safe.
Dr Prun Bijral, Medical Director at Change Grow Live has been collaborating with Collective Voice and the NHS Substance Misuse Provider Alliance to address this challenge.
Dr Bijral recently presented key findings and action points from the group’s report (Improving Clinical Responses to Drug Related Deaths) at an event in Halifax designed to maximise the opportunities offered by the 2017 Drug Strategy and refreshed Clinical Guidelines for the sector to improve outcomes for service users.
He identified five key areas for action:
1. Use of data to identify those most at risk of overdose
Service user records, care plans and risk assessments provide a rich source of information that can be used to identify high-risk individuals and target interventions accordingly.
2. Safe, recovery-orientated drug treatment
It is vital to deliver safe and effective recovery-oriented treatment programmes. Treatment which combines opioid substitution with individualised therapeutic interventions should be delivered for as long as necessary to achieve a positive outcome without imposing time limits.
3. Harm reduction to prevent overdose
Harm reduction approaches should it at the heart of treatment. Needle exchange services combined with education, pathways into treatment and re-engagement strategies for those who lapse are vital. Staff should be trained to recognise risk and trigger points and the overdose reversal drug Naloxone should become a core element of treatment, not an add-on.
4. Meeting physical and mental health needs
Staff should be trained to recognise how both physical and mental health needs impact on overdose risk. For example, recognising psychological crises and addressing social and health issues that increase overdose risk, such as homelessness, unemployment, smoking and general health needs.
5. Improving access to treatment
It is important for services to reach out to those not currently in treatment. Services need to be as attractive and accessible as possible to encourage people to seek help, offering minimal waiting times and swift referrals. Outreach is necessary for hard to reach groups and engagement with the wider community, including family members, employers, first responders and others who come across vulnerable people in the course of their work, and all play a part. Heroin-assisted treatment and drug consumption rooms should also be considered as a means of reducing deaths.
Across all these actions, it remains essential to consult with service users and listen to their voices and experiences to ensure approaches and strategies are relevant and appropriate. Educating and equipping service users to use interventions such as naloxone have proven highly effective and demonstrate that service users play a key role in reducing drug-related deaths in their communities.
The growing use of fentanyls is a further reminder that the drug world constantly throws up new challenges for treatment providers. The sector must continually strive to stay ahead of developing problems and share knowledge and expertise to devise new approaches to preventing drug-related deaths.