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MEDICATIONS IN RECOVERY APPLICATION IN PRIMARY CARE
10th April 2013
Alison Keating
PHE (London) Head of Drugs and Alcohol
The group’s final report
A lot done.
A lot more to do!
Some people recover fast, some don’t – all need recovery support.
2 Medication in Recovery – Application in Primary Care
Adaptive treatment Plan, review, optimise (measure) Phases:
Engagement and stabilisationPreparation for changeActive changeCompletion
Layers (of intensity):StandardEnhancedIntensive
3 Medication in Recovery – Application in Primary Care
What works to improve recovery rates?
• Focus and detail, clear planning, local champions and leaders and aiming high
• Frequent care planning and review – is what we are doing still bringing benefits?
• Decent length key work sessions
• Psychosocial interventions as well as methadone
• Flexible prescribing
• Considering client strengths
• Recovery conversations
• Offers of detoxification and intensive support for detoxification
4 Medication in Recovery – Application in Primary Care
What works to improve recovery rates?
• Getting abstinent in the first 6 months of treatment • Mixing with abstinent peers who have been through the system and
succeeded• Visible treatment exits and role models• Peer support and mutual aid and aftercare activity• Employment, Housing support – working at least 1 day a week• Family support• An expectation that clinical treatment will end• Different approach for those who represent to treatment
5 Medication in Recovery – Application in Primary Care
Mutual Aid: A NICE Approved Asset
6 Medication in Recovery – Application in Primary Care
Issue date: July 2007
NICE clinical guideline 51Developed by the National Collaborating Centre for Mental Health
Drug misuse
Psychosocial interventions
Avoid unintended consequences
Let’s be clear:
This is about increasing recovery-oriented ambition and progress for individuals and in systems where there is not currently enough of it
It is not about destabilising - to the point of unacceptable risk - individuals who are deriving benefit from OST.
7 Medication in Recovery – Application in Primary Care