1. MEDICATIONS IN RECOVERY APPLICATION IN PRIMARY CARE 10 th April 2013 Alison Keating PHE (London) Head of Drugs and Alcohol

2. The groups final report A lot done. A lot more to do! Some people recover fast, some dont – all need recovery support. 2Medication in Recovery – Application in Primary Care

3. Adaptive treatment Plan, review, optimise (measure) Phases: Engagement and stabilisation Preparation for change Active change Completion Layers (of intensity): Standard Enhanced Intensive 3Medication in Recovery – Application in Primary Care

4. What works to improve recovery rates? Focus and detail, clear planning, local champions and leaders and aiming high Frequent care planning and review – is what we are doing still bringing benefits? Decent length key work sessions Psychosocial interventions as well as methadone Flexible prescribing Considering client strengths Recovery conversations Offers of detoxification and intensive support for detoxification 4Medication in Recovery – Application in Primary Care

5. What works to improve recovery rates? Getting abstinent in the first 6 months of treatment Mixing with abstinent peers who have been through the system and succeeded Visible treatment exits and role models Peer support and mutual aid and aftercare activity Employment, Housing support – working at least 1 day a week Family support An expectation that clinical treatment will end Different approach for those who represent to treatment 5Medication in Recovery – Application in Primary Care

6. Mutual Aid: A NICE Approved Asset 6Medication in Recovery – Application in Primary Care Issue date: July 2007 NICE clinical guideline 51 Developed by the National Collaborating Centre for Mental Health Drug misuse Psychosocial interventions

7. Avoid unintended consequences Lets be clear: This is about increasing recovery-oriented ambition and progress for individuals and in systems where there is not currently enough of it It is not about destabilising - to the point of unacceptable risk - individuals who are deriving benefit from OST. 7Medication in Recovery – Application in Primary Care