‘I’m not a lone soldier’ – A multi-disciplinary response to the management and treatment of benzodiazepine use within the general practitioner setting. Ballymun GP Community Partnership Addiction Project

Background Partnership Response; Hosted and situated in the Ballymun Family Practice, Delivered by Ballymun Youth Action Project, Funded by the Ballymun Local Drug & Alcohol Task Force. As a response to a study by the Ballymun Youth Action Project (BYAP) in 2004 entitled Benzodiazepines – Whose Little Helper Explored work by Rolande Anderson (ICGP) in the area of alcohol as a useful template for the development of services to complement GP practices in the area of benzodiazepines. Project commenced 2006; evaluated 2011

KEY project CHARACTERISTICS Accessibility and Engagement - ease of referral system, engages those who would not necessarily attend addiction services Allows for earlier intervention and early warning systems Discreet, non stigmatising Flexibility Allows for integration of medical and psychosocial model (e.g. supported reduction plans) Enhances links within primary health care provision and across local support services when required. Creates a culture of co-operation and intervention beyond benzo use (e.g. alcohol, methadone clients). Assists in the tracking of benzo and Z related issues.

I have taken up someone who is already a patient who was buying on the street and has a heavy problem and where I would have ran from it because I couldn’t cope with it, I agreed to take her on to detox her. And the reason I couldn’t cope with it was because I didn’t feel skilled but I feel if she is in counselling, addiction counselling and committing to that, I feel I can deliver my bit and I feel more secure that I’m not a lone soldier. (PRACTICE1, GP1) (Carrigan, 2011: 34) Carrigan, J (2011) Chains of Addiction & Links of Support: Responding to Benzodiazepine use in Ballymun, A GP-Community Partnership Addiction Project. Ballymun Local Drugs Task Force and Ballymun Family Practice: Dublin.

Aims To assist those currently using benzodiazepines and for those seeking a prescription for benzodiazepines To provide a service for those seeking and wishing to address their substance misuse and/or related issues; those wishing to detox, and those seeking residential/ further treatment. G.P. Patient Addiction Counsellor What is it It is 9 hours a week provided by two addiction counsellors Its within the local GP practices or within a local drug / alcohol service’s building

Transfer to yap for complimentary services

Who 50 Clients accessed the service 32 Male and 18 Female

Valium and zoplicone experiencing challenges or seeking medication for overwhelming events, our role is to assess, negotiate and make recommendations A feature of presentations is dual diagnosis

Whats involved in getting here, From HRB treatment outcomes Tranferred stable – other YAP services

What have we learned its important GP’s are familiar with the current popular street Tablet use Addiction Counsellors are Addiction Counsellors Some Drug / alcohol users don’t want to be seen in a drug / Alcohol service Value of onsite Multidisciplinary involvement We are better together The importance of on the ground communication between prescribing GP’s and drug workers, the value of relaying information of current popular trends of street tablet use Appropriate referrals – mental health, general counselling Uniqueness co location Transfer from GP practice to yap building Ongoing reviews to ensure we don’t slip into working in silos