"things have changed at Guernsey House"

About: Guernsey House / Primary care addiction service Sheffield (PCASS)

(as a service user),

Initially everything (some years ago) everything seemed great about the clinic, doctors seemed to understand and actually listen and take notice of patients viewpoints. Doctors had a lot of grace as regards patients who felt they needed maintenance rather than detox which obviously had been tried and failed many times in past. Recently things seemed to change, feel like there is less listening by doctors, massive emphasis on reduction leading to detox, and once again I go around the roundabout.

I think they should listen more to methadone alliance. More prescribing practices leading to drug of choice practices proven to work in other places. (These measures would stop dealers).

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Response from Guernsey House

I am really sorry to hear that you have felt that things have got worse at Guernsey House due to the new emphasis on detox and the ‘recovery agenda’. It is true that we have been encouraged to focus on helping people to become drug free if possible, whereas in the past we concentrated on getting previously untreated people stable on maintenance treatments to reduce the serious harm from illicit drug use.

However this is not just due to a change in political agenda. There is no doubt that our patients have got older and many have moved on and are not happy to see a future on permanent maintenance with all it entails. Also we have a different patient population as there are very few untreated long-term drug users desperately seeking treatment. In the past many people were on waiting lists for long periods and inevitably their first priority was to get stable and stay alive rather than aiming any higher towards being drug-free. Fortunately this is no longer the case as many of those original patients have become ready to move on with their lives and the newer patients are often at an earlier stage in their drug use so that it is easier to aim for detox.

There are also some people in our service who may have become quite dependent mentally on having a permanent maintenance drug. We have seen some of these benefit when they are encouraged to ‘take the plunge’ and lose the barrier between themselves and other people which is undoubtedly created by opiates- whether prescribed or not.

On the other hand we do recognise, as do our commissioners, that there are some people who for complex reasons cannot easily make the break from prescribed medication and who may need very long periods of ‘medically assisted recovery’, as it is termed in the Government’s new Drugs Strategy, in order to avoid the revolving door situation which you describe. We would hope that all doctors and other clinical staff at Guernsey House will continue to listen and communicate with patients and take these factors into account when developing a care plan with that person

Dr Jenny Keen

Clinical Director

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