Moving on from Methadone: Depot Buprenorphine Case Study in Wakefield

Traditionally Methadone has been first line opiate substitute prescribing, however Turning Point has increasingly introduced Buprenorphine as a treatment option for clients with opioid dependence, following a successful pilot in 2021.

Turning Point initially piloted the use of Buvidal in 2021 in Wakefield and now have in excess of 70 clients prescribed Buvidal (and growing), with only one client from the whole cohort who continued to use opiates. Clients are presenting in much better health and report to be re-engaging with families, living better-adjusted lives, and giving back to the community. The success of the project has led Camerus to approach Turning Point to become a Centre of Excellence and the CQC report stated that this offer had been proven to be outstanding.

The project has been successful in:

• Promoting patient choice.
• Alleviating pressure on pharmacies related to dispensing and contending with often challenging behaviours.
• Reducing criminality, promotes re-engagement with families, education and employment.
• Addressing substance use, reduces the risk of overdose and drug related deaths.

Turning Point’s experience of criminal justice patients has been particularly successful, with significant changes to patient lives, supporting a positive recovery and reducing re-offending. Turning Point has also witnessed improved outcomes with clients in the community. Clients are found to engage more positively with clinicians and recovery workers, engaging in more meaningful conversations about health, lifestyle, social interactions and generally getting their lives back on track.

Buvidal’s long-acting, injectable formulation means that it can be administered to patients weekly or monthly rather than daily, which other medications (such as methadone) require. This allows for greater flexibility in treatment for people with complex needs or chaotic lives and increases the chance of successful treatment completion.

Buvidal has allowed Turning Point to monitor clients more closely and identify issues early – being proactive to needs, rather than reactive to deterioration or crisis. This has led to a marked increase in retention of patients who previously presented as high risk, chaotic and continually dropping out of treatment.

Pharmacy reports are positive, this focuses on the strain that clients can bring around confrontation, violence, and aggression and more generally the time taken to prepare medication for clients. Interestingly, pharmacies have also reported cost savings, which they attribute to a reduction in shoplifting. Buvidal also lessens script generation, batch and prescription transportation and reduces our reliance on pharmacists to report concerns back which is has often been an issue in the past.