Opioid substitution treatment helping to make life changes
Opioid substitution treatment (OST) allows someone who is opioid-dependent the opportunity to make positive changes in their lives.
Someone who is dependent on drugs, such as morphine, codeine, tramadol, oxycodone and methadone, can feel more stable, better able to cope and more focused on the future by having a managed, daily dose of an alternative to opioid medication.
However, people prescribed OST are vulnerable. They have a shorter lifespan, often have bad veins, have a higher risk of experiencing cardiac issues, and often lack trust in health providers. They experience significant inequities in terms of access to healthcare, and ongoing monitoring of their physical and mental health.
A project was launched to help overcome some of these barriers involving pharmacists Megan Peters, Deirdre Magee, Rebecca Lukey and a consumer representative working alongside 30 tāngata whaiora (people seeking wellness) with opioid dependence.
Rebecca Lukey, Mental Health and Addictions Clinical Pharmacist, says community pharmacists are well-placed to help people receiving OST.
“They are more accessible, they see the person every day when they come and pick up their OST dose, and the pharmacist doesn’t have any influence over the amount of OST dispensed,” she says.
“The person receiving treatment doesn’t have to sit in a waiting room and feel they are being judged — they are just another person picking up medication at their pharmacy.”
Rebecca says the project team also found the tāngata whaiora were experiencing difficulties accessing blood tests, and felt stigmatised and disempowered when they discussed genuine health concerns.
Megan Peters and Deidre Magee, both pharmacists at Victory Square Pharmacy, supported tāngata whaiora on OST to engage with health providers.
“Many of the pharmacists did a full medication review, took people to their GP, acted as clinical advocates at appointments, and they followed up with the person’s GP,” Rebecca says.
The pharmacists also provided education sessions to GP practices and junior hospital doctors about OST and its physical health implications. They developed information sheets, addressed barriers to accessing electrocardiograms and blood tests necessary for cardiometabolic screening, and updated Health Pathways information in consultation with the Nelson Addiction Service.
This hands-on approach requires a significant commitment but Rebecca says the results have been encouraging.
“Many of this group have had a rough past and they just want to get on with their lives. We have raised awareness about some of the issues they face, and we have improved some of the pathways for them.”
“The health providers are also more informed about OST and tāngata whaiora are more willing to be assertive about their health.”
The Community pharmacists improving healthcare for a vulnerable population project won the He Tāngata / The people category in the 2020 Health Innovation Awards