Supervised Consumption

Services

Page Contents
Overview
Have a Heroin Addiction & Want to get Help?
How to get treatment for Heroin
Increased Risk of Overdose After Detox
Inpatient Detox and Rehabilitation
Other Support Mechanisms for Opiate Addiction
Life After Detox

At P&S Chemist, we can play an important role in the provision of harm reduction services and in the treatment of drug misusers. We dispense substitute drugs, for example, Methadone and Buprenorphine for detoxification purposes, supervising the self-administration in our pharmacy to ensure that the dose has been administered to the patient, minimising the possibility of misdirection of controlled drugs and to reduce incidents of accidental death through overdose.

Through a process of daily contact that we have with our supervised administration patients, we can monitor and provide advice on the patient's general health and well-being. In order to provide our service users with the help and assistance to access further advice and help as necessary. This can involve the referral to specialist treatment centres or other health and social care providers where appropriate. As part of the shared care service, that aims to provide the maximum positive impact this service can for our patients.

If you are part of the Supervised Administration Service or want to join this service at P&S Chemist, you can be assured that the expectations, as outlined by the Primary Care Trust (PCT) and listed below, will be met.

At P&S Chemist we will provide a sufficient/suitable level of privacy and safety.
P&S Chemist will present the medicine to the service user in a suitable receptacle and will provide the service user with water to facilitate administration and/or reduce the risk of doses being held in the mouth.
Terms of a three-way agreement will be set up between your prescriber (your GP), P&S Chemist, and yourself, as the patient to agree on how the service will operate, what constitutes acceptable behaviour by the patient, and what action will be taken by your GP and P&S Chemist if the user (you), do not comply with the agreement.
A specific client and P&S Chemist agreement that details the arrangements for the service, which is signed by you and our pharmacist at P&S Chemist.
P&S Chemist has a duty to ensure that pharmacists and staff involved in the provision of the service have relevant knowledge and are appropriately trained in the operation of the service.
The pharmacy contractor has a duty to ensure that pharmacists and staff involved in the provision of the service are aware of and operate within the standard operating procedures based upon the local PCT guidelines.
P&S Chemist will maintain appropriate records to ensure effective ongoing service delivery and audits.
Our pharmacists will share relevant information with other healthcare professionals and agencies, in line with confidentiality arrangements.
The PCT will provide details of relevant referral points that our pharmacy staff at P&S Chemist can use to signpost service users who require further assistance.

Have a Heroin Addiction & Want to get Help?

Are you addicted to heroin and you want to stop? If so, you can ask your General Practitioner or your local drug treatment service for help. An individual with a drug addiction is entitled to the same confidential NHS care as anyone else who has a health problem. If you are not yet ready to stop, you can still get help to ensure you stay safe and healthy.

How to get treatment for Heroin

Heroin is an opiate drug. Other opiate drugs include codine, opium and morphine. if you need treatment for addiction to heroin or another opiate drug you can either see your GP or contact your local drug treatment service, via your postcode on the NHS find Drug Addiction Services webpage, located here. At your first appointment, your doctor or drugs worker will ask you questions including:

How much heroin do you take?
Whether you are using any other drugs or alcohol?
How your physical and mental health is?
What your personal circumstances are, for example, where do you live and whom you are living with?
Whether you have had treatment for drugs before?

They will also ask you for a urine sample. This will be tested to confirm that you are using heron. You will then be given a key worker who will help you put together a personalised treatment plan, and who will meet you regularly throughout your treatment and will help you to decide between the two different approaches, either maintenance therapy or detox therapy to stop you from using heroin. These two approaches are outlined in more detail below:

Maintenance therapy: This allows you to switch from heroin to a heroin substitute, such as methadone or buprenorphine. You then stay on a stable dose of the substitute.
Detox: This allows you to switch from heroin to a heroin substitute, then gradually withdraw from the substitute so that you are completely free from both.

Both treatments aim to help you withdraw from using heroin gradually, as this will assist and ease the magnitude of your withdrawal symptoms. Whilst undergoing your maintenance or detox therapy, it is usual for you to be living at home, as the familiar surroundings of the home can assist your treatment by reducing any potential anxiety. Although it is worth noting that detoxing from heroin use whilst living at home can take up to 12 weeks. If you find your chosen method to be difficult or unhelpful, you can switch from maintenance therapy to detox at any time.

Increased Risk of Overdose After Detox

It is very important to remember that if you are on the Supervised Administration Service and are in detox or have completed your detox therapy, the detox process lowers your tolerance to heroin. Consequently, you are at a much higher risk of overdosing afterwards.

Inpatient Detox and Rehabilitation

Although it is the general rule that the Supervised Adminstration Service is usually conducted whilst you live at home, in some instances, this can be offered as a hospital inpatient or in a specialist residential rehabilitation premises; these provide an intense programme of support and care aimed at people who have difficulty becoming drug-free in the community. Although, this is dependent upon the following criteria:

You need medical help for other physical or mental health problems.
You need to detox from alcohol or another drug, such as benzodiazepines, as well as heroin.
Community detox has not previously worked for you.

Other Support Mechanisms for Opiate Addiction

Whilst you are undergoing your therapy, you will be offered additional help and support whilst you come off heroin. These help and support mechanisms may include:

Talking therapies: You may be offered a talking therapy such as Cognitive Behaviour Therapy if you need help with anxiety or depression while you are detoxing.
Support groups: Your key worker should provide details of local self-help groups, such as Narcotics Anonymous or SMART Recovery.
Support for family and carers: Your key work can organise support for people close to you, who are affected by your addiction.
Help to stay healthy: This could be anything related to your therapy, from the provision of advice on healthy eating to tests for potential infections such as HIV etc.
Incentives: You may be offered rewards, such as vouchers or doses of methadone to take home, for persevering with your treatment and staying off heroin.

Life After Detox

Once you have completed your detox programme, your key worker and drugs team will continue to support your progress for up to six months to help you stay off heroin and prevent a relapse. This support may also include help with day-to-day issues such as housing, finding employment or developing further skills and knowledge by studying an education programme.

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Page last reviewed: 06/10/2022
Next review date: 06/10/2024