Naloxone: The Welsh Experience. A presentation by Ifor Glynn, Director, Swansea Drug Project, Wales (www.drugs.ie)

The Irish group

In early 2012, The Ana Liffey Drug Project convened a ‘Naloxone Advisory Group’ with the following objectives: 
  • (a) to pilot provision of Naloxone in Ireland for administration by opiate service users and their families, with the aim of reversing overdose; 
  • (b) to evaluate provision the pilot with the aim of improving the project, and – if proven effective then – to roll out national Naloxone provision.
The group is comprised of the following individuals:
Dr Gerard Bury, UCD; Dr Austin O’Carroll, Safetynet; Dr Des Corrigan,  TCD; Vivian Guerin,  Probation Services; Sadie Grace, National Family Support Network; Tony Duffin, Ana Liffey Drug Project; Caroline Gardner, Progression Routes Initiative.

The Welsh experience

 On 6th July 2012, I attended the meeting of the group where Ivor Glynn, Director of the Swansea Drug Project, gave a presentation entitled: Naloxone- The Welsh Experience, to the Irish Naloxone Advisory Group. You can view this video presentation below (courtesy of drugs.ie) http://drugs.ie/features/feature/naloxone_the_welsh_experience

Trust: the usual suspect in the addiction story

Believe me, or not, trust is something that has been emphasized in addiction treatment for many years. One can hardly argue that it has become one of the usual suspects in the life stories of most recovering drug users.

In this post, I write about two main findings of my latest research published in the current issue of the Czech academic journal Adiktologie (Addictiology). Although they may not be the key findings, which I discovered, this blog gives me an opportunity to illuminate what I feel people should take away from this paper.

 

 


This comes with no surprise – trust is key for building or restoring relationships of all people. No matter if they have drug problems, or not. In this way, my research confirmed what common sense tells us without any special knowledge of research. Re-prioritisation of relationships during treatment was facilitated by the experience of help, support and restoration of trust in relationships.

Because I was able to look at the pre-recovery years of drug users lives, when they actively used drugs, I could go with the trust issue a little further. Changes in relationship priority during active drug use occurred on the basis of barriers (e.g. the need to obtain drugs, stigma), which restrained active drug users from engaging in and maintaining the social relationships.

 

This research has further deepened my understanding of how problem drug users function and indeed how similar they are to people who don’t have drug problems. Some readers may not like this, but they may be less different to ‘us’ than we thought. The key factors that keep them function in a way that is hardly acceptable  by the main-stream population are drug-related barriers. These barriers prevent them from engaging in the usual social life pleasures, such as keeping in touch with non-drug-using friends, visiting parents etc. My research highlighted that they don’t do these things because they have different priorities, which are not compatible with them (See Figure 1 below).

Saying that they are not bothered with relationships or that they’ve no interest in them is too simplistic, and as suggested by this research, not true. Other research showed that people with drug problems do engage in social relationships, pro-social activities, social relationships, raising children – they just don’t do it in a way that ‘we’ are willing to accept. The question that remains to be answered by future research is what would happen if the barriers of engaging in culturally-acceptable social activities were removed? Would ‘they’ be more like ‘us’? The first signals supporting this question come from the opioid agonist treatment. People maintained on pharmaceutical opioids, substituting their illicit drug use, lead more stable lives, commit less crime and have better chances of being employed than people without these substitutes.


Original abstract:
Background: interpersonal problems among drug users (DU) are frequent, are related to other problems, and improve during the addiction treatment.
Aims: to better understand changes in relationships which occur in the course of drug use and drug treatment, as well as their subjective appraisal by ex-drug users, using retrospective methodology.
Method: semi-structured interviews with DUs in a therapeutic community (TC) were analysed with descriptive-interpretive method. The coding of interview transcripts into categories was performed in two phases using qualitative software NVivo 7. Five interviews were coded in the pilot phase, followed by an audit by an external psychologist and progressive coding of the rest of the transcripts, with data saturation being reached in the second phase.
Participants: nine male and one female client, aged 18-36 years (mean: 25.9), participated in the study and the length of their stay in the TC was 2-35 months (mean: 9.9). The approximate mean age of drug use onset was 15.6 years (12-28).
Results: the analysis provided 21 categories which were divided into three domains based on chronological order. Changes in relationship priority during active drug use occurred on the basis of barriers (such as the need to obtain drugs and stigma), which restrained active DUs from engaging in and maintaining their social relationships. Re-prioritisation of relationships during treatment was facilitated by the experience of help, support and the restoration of trust in relationships.
Conclusions: this study builds on the previous work exploring the broad issue of social consequences of drug use and offers clients’ perspective on this topic.
Cite as: Klimas, J. (2012) Interpersonal relationships during drug use and treatment from the perspective of clients in a therapeutic community. [Interpersonálne vzťahy v priebehu užívania drog a liečby závislosti z pohľadu klientov/iek v terapeutickej komunite.]. Adiktologie (12)1, 36-45
More at: www.adiktologie.cz

Figure 1. Evolution of relationships during drug use, addiction and treatment

 

Alcohol screening and brief intervention among drug users in primary care: a discussion paper

New paper out now, here
Summary:

Background Problem alcohol use is common among problem drug users (PDU) and associated with adverse health outcomes. Primary care has an important role in the overall stepped approach to alcohol treatment, especially screening and brief intervention (SBI). Aim To discuss three themes that emerged from an exploration of the literature on SBI for problem alcohol use in drug users attending primary care. Methods Material for this discussion paper was gathered from three biomedical databases (PubMed, PsycINFO and Cochrane library), conference proceedings and online resources of professional organisations or national health agencies. Results Themes discussed in this paper are: (a) the potential of primary care for delivery of alcohol SBIs to PDUs, (b) screening methods and (c) application of brief interventions to PDUs. Conclusions Although SBI improves health outcomes associated with problem alcohol use in the general population, further research is needed among high-risk patient groups, especially PDUs.

Integrative GP Research Group started in Dublin

How important is it to integrate research? Why do we need to integrate it at all? Well, because things are disintegrated!
This is the first blog post about the General Practice Research Group (GP), established on May 2nd, 2012 in Dublin, Ireland. It contains my musings about the first group meeting and research plans for future. I think I’m not capable of writing an exquisite research blog, but I will write about research because it consumes 80% of my waking hours.
The six of us met officially as a group on Wednesday. Finally! We made it and a new research group was born. We met to establish a research group which should be integrative. It means that we will work together to use our research for improving lives of people that we care about, patients, clients, participants… we call them different names depending on the situation.
Doing things together is much more fun than on our own. Especially if we talk about things that we are passionate about. And passion we have! It was clear in the lengthy discussions that we mean business. We spent about half of a day sunk in these talks and then I left.
After the meeting, all planned to go for a personalised sight-seeing tour around the UCD Belfield campus. In Walter’s words:

“Tour 5’ for the non-UCD people, which might involve a tour of the new(ish) Health Sciences Building, the (in)famous Belfield bar (home to the legendary Pre-Med class party of 1989) and the soccer pitch where the ‘Casual Heroes’ soccer team won division 3B of the ‘UCD Superleague’ in 1993.”