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Community Detox for Cardiff

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caroline gardner

on 20 September 2012

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Transcript of Community Detox for Cardiff

Who we are? Why do we
need protocols? How do they work? What helped in setting it up? Policy to Practice 'The doctor told me I wasn't ready and he couldn't see it changing any time soon'. 'The doc said there's no way I am being
precribed benzo's when I have been
using so many already'. 'We don't have enough time'.

'There are serious risks'.

'If we give benzos, the word
will get out'. Literature Review*

Not strong evidence (Cochrane review)
Protocols (ASAM, NICE 2012)
Psychosocial supports (WHO, U.K guidelines)
Slow detox (Aston1994, Irwin1999)
Good assessment and care planning and adherence to local protocols are prerequisties for considering prescribing benzodiazepines. The aim should be to prescribe for a limited period of time. (UK guidelines clinical mngemnt)
*lit review available on request. Benzos implicated in 31% of all deaths by poisoning.

Between 2003-2008 the number of cases reporting benzodiazepine as a problem increased by 63%.

1 in 10 in GMS pop being prescribed benzos.

62 cases of benzodiazepine detoxification. Community Detox Pilot
16/ 29 referrals went on to detox
7/16 successfully detoxed
7/16 still engaged at time of evaluation
4/29 key working but not detox Doctor Key Worker Process
weekly meetings
6 months aftercare Service signs off on competency in RP and CP
Must recieve line management supervision Process
4 meetings
2 weeks drug diary Risk Management
Discuss with doc and sign off with Key Worker. Weekly meetings, agrees to contact KW, Detox to 0. Broker Client 2008 2012 2009 Initial pilot Launch National Roll Out Influential and Relevant Head of Addiction Services, Dr. B Sweeney
Head of Safetynet, Dr. Austin O'Carroll
GP Co-ordinator, Dr Des Crowley
Service User Rep - Ruaidrhi McAuliffe
Community Reps - Tony Duffin, Joan Byrne Doctors, nurses,
key workers, managers Evaluation Clear roles Influential and
- Psychiatrists
- residential Doctor, Nurse, Key Worker, Development Officer Anyone through self referral, agency or doc referral. More GPs than clinical docs. More NGO than HSE. 75%
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