reasons for prescriptions of benzodiazepines to oldham patients*

Reasons for prescriptions of benzodiazepines to Oldham patients*

Prescribing period for patients (number of weeks between first and latest prescription)

The ADS BenzodiazepineWithdrawal Service

“I am extremely proud of the Benzo service in Oldham and look forward to the day when, with appropriate investment, we will be

able to deliver essential services like this one in all the areas in which we operate”

Rhona Bradley, Chief Executive ADS

ADSADS :

• Registered Charity• Operating since 1973• Turnover of over £9.5m• 100 projects/services• 300 staff • 250 volunteers• Operates from 30 permanent and outreach centres• Footprint in the North of England and Midlands

ADS values are:•Flexible and Responsive•Professional•Innovative•Empathy•Respect

Oldham TRANX

• Oldham Tranx was formed 22 years ago, by Mike Levin's, a former CPN Nurse. • It meets each Monday,11.00am-1.00pm• The Group listens to each others concerns, advice is offered• Members are at all stages of recovery, so pass on their knowledge to others. Very friendly

and constructive advice is given. Prof. C.H.Ashtons Withdrawal Protocol is used for reference and the BNF. For complex withdrawals, Barry can contact Prof .Ashton direct and she kindly responds. Members are given each others contact details, for further support. Withdrawal is not 9 to 5 only.

• Had visitors from Australia, Canada, USA, Ireland and from outside our catchment area of Oldham.ie. Staffs, Liverpool, Huddersfield, Blackburn. There are no similar services in their immediate area. It arranges guest speakers from the Medical Profession, DWP and Oldham PCT and MPs.

• Oldham Tranx is all voluntary, No-one is paid. The funding is maintained through small local grants, Donations and bequests. No funding from National or Local Authorities.

• It advertises in the local free Newspaper, Local and National articles, referrals from GPs and Mental Health Services. In addition our details are on various websites.

• It liaises with Addiction Dependency Solutions, Oldham. ADS won the contract awarded by Oldham PCT, to supply the only NHS funded Benzodiazepine Withdrawal Service for legally addicted patients. This has resulted in 2 Benzo nurses working out of GPs Surgeries, in the Oldham area, in order to withdraw patients safely and at the patients own pace. They use complimentary medicine, including acupuncture, relaxation, CBT, head massage and other techniques. Oldham Tranx members have access to all these.

• ADS have had the humility to learn from Tranx members and sit in on discussions, to listen and learn.

The Benzo Service

A decade of evolution

Aims and Values

• Proactive engagement• Proactive intervention• Long term wellbeing• Save the NHS money in the future• Creates speed of access• Supports GP’s with resources and time• Expertise• ‘Clean up’ GP surgery’s

ADS’ approach

• Approach GP surgery’s• Specialist worker given access to GP data• Target medical history• Formulates a targeted client list• Letter’s sent out. Access points identified• Benzo clinic set up for GP surgery. Reduction plan agreed• Worker writes the new weekly prescription, doctor signs it off • Duration:16 weeks• Aftercare counselling and acupuncture. Address underlying

reasons for medication use • Once stabilised – we move on; A targeted task force

Key points

• Many letters sometime required. Very proactive• ADS works on the basis of reducing a client’s medication by

1mg per month over 16 weeks before a break in treatment or discharge

• Each person is different (some people may reduce quicker)• Counselling and holistic care provided alongside reduction

plan as part of the Benzo clinic• Support network of the Oldham Tranx Group vital to

treatment • 13 GP’s at any one time. Identified as the threshold of one

specialist worker

Key findings

• Reduction regimes follow the Ashton protocol and are tailored to individual need

• During 2011-12 the service worked with 120 clients• The drugs most commonly identified at assessment were

diazepam, zopiclone and temazepam • 61% of discharge clients were in treatment for less than 12

months• 42% had stopped using Benzodiazepines• GP’s found the practices ‘always’ useful

Problems

• ADS and Oldham PCT were reactive.• Full treatment which brings success needs the support of a

volunteer peer support group• This needs a leader. We are lucky to have Barry• This leader needs passion and determination in order to

highlight ‘need’ in communities• It takes time to find these community volunteers• ADS aims to bring forward a network to support the

development of these specialist volunteers• Lack of funding means ‘need’ has to be evidenced

Success