The experience of an increase in the injection of ethylphenidate in Lothian April 2014–March 2015

Background and aimsNew psychoactive substances are causing increasing harm across the UK but the use of new psychoactive substance by injecting has become a significant problem within Lothian since the beginning of 2014. Data indicate a rapid rise in the number of existing drug injectors, particularly heroin injectors, moving to new psychoactive substance injecting. This paper reports the experiences within Lothian of a sudden increase in injecting of ethylphenidate over one year. A temporary class drug order was placed on ethylphenidate on 10 April 2015, and as yet the effects of this are unknown.MethodsData specifically relating to new psychoactive substance recorded during injecting equipment provision transactions conducted by the NHS are reported. A survey was utilised to gather more detailed data from new psychoactive substance injectors.ResultsInjection of new psychoactive substance, including ethylphenidate has had significant adverse effects on physical and mental health. Risky behaviour such as sharing of equipment is known, and there are risks of transmission of infections.ConclusionThe rapid increase in injecting ethylphenidate has had a major impact on injecting equipment provision services, health services and public health. More work is required to identify routes to recovery

The experience of an increase in the injection of ethyphenidate in Lothian, April 2014 - March 2015 [Report]

Alison Coull - ORCID: 0000-0002-3166-0699 https://orcid.org/0000-0002-3166-0699Item not available in this repository

Using microdosing to induct patients into a long-acting injectable buprenorphine depot medication in low threshold community settings : a case study

Healthcare innovation has never been more important as it is now when the world is facing up to the unprecedented challenges brought by the COVID-19 pandemic. Within addictions services in Scotland, the priority has been to tackle our rising drug related death rate by maintaining and improving access to treatment while protecting frontline workers and managing operational challenges as a result of the pandemic. We present here a case study of five patients with opioid use disorder whose treatment represents a confluence of three important Medication Assisted Treatment (MAT) service innovations. The first was a low threshold drop in and outreach MAT service to rapidly and safely initiate opiate replacement therapy (ORT). The second was the provision of a microdosing regimen to enable same day induction to oral buprenorphine while minimizing the risk of precipitated opioid withdrawals and/or treatment disengagement. The third was rapid transitioning to an injectable long-acting buprenorphine depot which reduced unnecessary face to face patient contact and treatment non-adherence. This case study of five patients highlights the valuable role that buprenorphine microdosing can play in making induction to long-acting buprenorphine depot feasible to a broader range of patients, including those on a high dose methadone treatment regime.Publisher PDFPeer reviewe

Using microdosing to induct patients into a long-acting injectable buprenorphine depot medication in low threshold community settings:a case study

Healthcare innovation has never been more important as it is now when the world is facing up to the unprecedented challenges brought by the COVID-19 pandemic. Within addictions services in Scotland, the priority has been to tackle our rising drug related death rate by maintaining and improving access to treatment while protecting frontline workers and managing operational challenges as a result of the pandemic. We present here a case study of five patients with opioid use disorder whose treatment represents a confluence of three important Medication Assisted Treatment (MAT) service innovations. The first was a low threshold drop in and outreach MAT service to rapidly and safely initiate opiate replacement therapy (ORT). The second was the provision of a microdosing regimen to enable same day induction to oral buprenorphine while minimizing the risk of precipitated opioid withdrawals and/or treatment disengagement. The third was rapid transitioning to an injectable long-acting buprenorphine depot which reduced unnecessary face to face patient contact and treatment non-adherence. This case study of five patients highlightsthe valuable role that buprenorphine microdosing can play in making induction to long-acting buprenorphine depot feasible to a broader range of patients, including those on a high dose methadone treatment regime