Substance Misuse
Our aims are:
To get you safe and legal and to give you the opportunity to have a better life.
We promise:
To listen to you and to give you what you want and need within the limits of what is safe and legal.
We ask you:
To respect us, the pharmacists, and our other patients.
What’s on offer?
Appointments – for new and regular patients.
Emergency drop in clinic daily from 3-5pm
The drop in is not available for new patients.
It is for patients with urgent problems only such as:-
You have missed an appointment but your prescription is due.
You are experiencing problems with your medication and require immediate attention.
Who we treat
Generally homeless people and those in unstable accommodation in the Northampton area but also our regular patients who we’ve treated before.
And we’ll try to treat people you live with to make things easier for you
The plan
You make an appointment for an assessment
We decide together what treatment you need
You start as soon as possible, within 3 weeks, unless our clinic is full up
You’ll get a daily prescription, supervised by the chemist to start with
The options
If you are homeless and have had a heroin problem for sometime, a period of stabilisation with a replacement prescribed drug such as Subutex or Methadone is best
If your problem is other drugs or alcohol we can help with that too
If you want a blocker after stopping heroin, we can do that
We have a counsellor and a support worker and we have housing and money advice clinics held here
We can help with anxiety and depression and other things going on in your head
Starting Treatment with Subutex or Methadone
No drugs for 12 hours before
Be here for your appointment time
Be ready to give a urine specimen when asked
Make sure you keep the start day free from any other commitments
It’s different for each person but we usually want you to stay here for up to 90mins to make sure you are OK
Unfortunately we can only give you 40mls of Methadone on the first day in line with National Guidelines. Subutex is usually up to 8mg. on the first day
For the first 2-3 days we will expect you to attend the surgery daily to see how you are getting on and decide between us whether the dose you are on is OK for you.
On Treatment
We like you to attend the clinic at your appointment time so you can see the same person each time. If you get in a mess however, you can phone up or drop-in to our emergency clinic which we hold every day from 2-3 pm Please be ready to give a urine sample any time you come to the clinic – there are good reasons for this and we’ll explain why
We recommend you stabilise on these drugs for at least 3-6 months, but you can stay on them as long as you think you need to. Don’t think you can stop without support.
You won’t feel withdrawal symptoms for 1-2 days at least if you stop Methadone, longer with Subutex, so don’t be tempted to think you can easily go it alone – discuss things with us.
What else do you need to know?
Methadone and Subutex take about 4 days to reach a steady level – so be patient. Try not to inject heroin during this time as it will mess up our assessment and you will take longer to stabilise. Also you will be at risk of overdose. This is one of the most risky times.
Remember that Subutex and heroin do not mix well. Subutex blocks the effect of heroin to some extent at any dose and blocks it completely as the dose increases from about 12mg to 16mg daily and beyond. This can be useful to you!
Prescriptions
Prescriptions can only be cashed on the date stated on them. The pharmacist is not legally allowed to cash them on another date. If you miss more than one pick up at the pharmacy you will be asked to come back to the clinic here to ask for a new prescription. If you lose your prescription or the dispensed medicines they will not automatically be replaced. You should be able to understand why this is! You are not allowed to drive on Methadone or Subutex unless you have permission from the DVLA - it is your responsibility to inform them. Make sure you keep all medicines locked up and safely away from children
Alcohol
Alcohol is a drug too and interacts dangerously with other drugs – you are more at risk of overdose. It also damages your liver, more so if you have Hepatitis C or B. We can help you to control or stop your drinking.
Hepatitis B and C and HIV
If you’ve ever shared needles OR even equipment you are at risk particularly of having caught Hepatitis C which is very common. We can test you for it and offer treatment when you are stabilised. We also want to give you jabs to prevent Hepatitis A + B (you will need a course of 3 or 4 injections) HIV is uncommon amongst Northampton’s drug users but we do offer screening. HIV is now treatable
The next steps
Housing
Welfare Rights
Counselling
Volunteering
Off the Hook
AA
NA
Aquarius or other rehabs
CAN
Naltrexone
This is a blocker which you can start to take if you have come off drugs – i.e. had no heroin, codeine or dihydrocodeine (DFs) for at least 5 days, and have been off methadone or Subutex for about 10days – you take a tablet every day and it blocks the effect of any opiate drug. It can help you to stay drug free
Important reminders
Overdose Risk
The times people overdose most frequently are:
When starting or stopping treatment
Coming out of prison or hospital
At these times you may have lost your tolerance to heroin
Other Risks
If you get a stronger batch of heroin without realising