Sheffield Substance Misuse Services ANDY FALCONER (Team Leader)
SHEFFIELD TREATMENT AND RECOVERY TEAM
Who we are and what we do A team of professionals that includes Nurses, Dr’s (Psychiatrists, GP’s, specialist doctors), social workers, drug and alcohol workers and admin staff. Experts in the field of substance misuse providing an expert assessment, opinion and recommendation around substance misuse and treatment. We aim to support people requiring help with substance misuse issues to be able to access services when they need it, at a time convenient to them and at a location that suits them. Open 8am - 8pm Monday to Friday. Supporting service users to achieve their goals and move towards recovery.
Opiate Service • City wide service. Based at Fitzwilliam Centre • Self referral via open access and referral by a professional • Providing assessment, treatment, needle exchange and recovery interventions • Support for people: – Using opiate based substances (Heroin, Morphine, Dihydrocodeine, co-codamol). – With problematic alcohol use alongside opiate use. – With co-morbid mental health problem • By qualified nurses, social workers and doctors and drug workers with specialist training in the field of substance misuse. • Drug workers trained in the field of substance misuse and counselling delivering recovery focussed interventions/treatment providing a menu of options for service users.
• Opiates, originally derived from the opium poppy, have been used for thousands of years for both recreational and medicinal purposes. • The most active substance in opium is morphine — named after Morpheus, the Greek god of dreams. Morphine is a very powerful painkiller, but it is also very addictive. • In the sixteenth century, laudanum, opium prepared in an alcoholic solution, was used as a painkiller.
• Morphine was first extracted from opium in a pure form in the early nineteenth century. It was used widely as a painkiller during the American Civil War, and many soldiers became addicted. • Codeine, a less powerful drug that is found in opium but can be synthesized (man-made), was first isolated in 1830 in France by Jean-Pierre Robiquet, to replace raw opium for medical purposes. • Throughout the early nineteenth century, the recreational use of opium grew and by 1830, the British dependence on the drug reached an all-time high. The British sent warships to the coast of China in 1839 in response to China’s attempt to suppress the opium traffic (Britain ‘supplying’ China), beginning the “First Opium War.”
• In 1874, chemists trying to find a less addictive form of morphine made heroin. But heroin had twice the potency of morphine, and heroin addiction soon became a serious problem. • Methadone was first synthesized in 1937 by German scientists Max Bockmühl and Gustav Ehrhart at the IG Farben company. They were searching for a painkiller that would be easier to use during surgery, with less addiction potential than morphine or heroin. • Unfortunately methadone is believed by many to be even more addictive than heroin.
• As recently as the 1950’s heroin (diamorphine) was a popular medicine prescribed by family doctors. • The Times 1955 stated there were only 317 addicts of ‘manufactured’ drugs in the whole of Britain… – Of which just 15% were dependent on heroin (47.5 heroin addicts)… – Mostly doctors or middle-class patients who could afford to sustain a habit. • Following pressure from the US, the UK implemented the Drugs (Regulation of Misuse) Act in 1964. • In 1971 the Misuse of Drugs Act (MDA) was passed, continuing measures in previous legislation, and classifying drugs into classes A (the most highly regulated), B, and C.
• The number of deaths from heroin are at the highest level since comparable records began. • In the past five years death rates have doubled in England, Wales and Scotland. • On average in 2016, every five hours someone died after using heroin and/or morphine. • Almost one in three drug overdoses in Europe happens in the UK, according to the European Monitoring Centre for Drugs and Drug Addiction.
Referrals + The Fitzwilliam Centre 143-145 Fitzwilliam Street Sheffield S1 4JP ( 0114 3050500 • Self referrals – telephone/walk in • Email: sct-ctr.fitzwilliamcentrereferrals@nhs.net
Non-opiate Service • City wide service for the people of Sheffield who use non-opiate based substances including cannabis, Khat, stimulants, NPS etc • Commissioned to deliver: – Needle exchange – Open access and assertive outreach – High volume, low intensity psychosocial interventions – Recovery interventions – Universal prevention/education – Learning schemes – SPICE Clinic – JUICE Clinic (Steroid Users) • By drug workers with specialist training in the area of substance misuse to support people in accessing structured treatment interventions.
• Cannabis was the most commonly used drug in the 2017/18 with 7.2 per cent of adults aged 16 to 59 having used it in the last year (around 2.4 million people).
• Research shows that 10% of regular cannabis users become dependent on it. Your risk of getting addicted is higher if you start using it in your teens or use it every day. • As with other addictive drugs, such as cocaine and heroin, you can develop a tolerance to cannabis. This means you need more to get the same effect. • If you stop using it, you may get withdrawal symptoms, such as cravings, difficulty sleeping, mood swings, irritability and restlessness. • If you smoke cannabis with tobacco, you're likely to get addicted to nicotine and risk getting tobacco-related diseases such as cancer and coronary heart disease. • If you cut down or give up, you will experience withdrawal from nicotine as well as cannabis.
New psychoactive substances (NPS) are drugs which were designed to replicate the effects of illegal substances like cannabis, cocaine and ecstasy. NPS began to appear in the UK drug scene around 2008/09. Previously legal hence the name ‘legal highs’ They fall into four main categories: • Synthetic cannabinoids – these drugs mimic cannabis and are traded under such names as Clockwork Orange, Black Mamba, Spice and Exodus Damnation. They bear no relation to the cannabis plant except that the chemicals which are blended into the base plant matter act on the brain in a similar way to cannabis.
New psychoactive substances (NPS) are drugs which were designed to replicate the effects of illegal substances like cannabis, cocaine and ecstasy. NPS began to appear in the UK drug scene around 2008/09. Previously legal hence the name ‘legal highs’ They fall into four main categories: • Stimulant-type drugs – these drugs mimic substances such as amphetamine, cocaine and ecstasy and include BZP, mephedrone, MPDV, NRG-1, Benzo Fury, MDAI, ethylphenidate.
New psychoactive substances (NPS) are drugs which were designed to replicate the effects of illegal substances like cannabis, cocaine and ecstasy. NPS began to appear in the UK drug scene around 2008/09. Previously legal hence the name ‘legal highs’ They fall into four main categories: • Hallucinogenic drugs – these drugs mimic substances like LSD and include 25i-NBOMe, Bromo-Dragonfly and the more ketamine-like methoxetamine.
New psychoactive substances (NPS) are drugs which were designed to replicate the effects of illegal substances like cannabis, cocaine and ecstasy. NPS began to appear in the UK drug scene around 2008/09. Previously legal hence the name ‘legal highs’ They fall into four main categories: • ‘Downer’/tranquiliser -type drugs – these drugs mimic tranquiliser or anti- anxiety drugs, in particular from the benzodiazepine family and include Etizolam, Pyrazolam and Flubromazepam.
THE LAW • 2016 Psychoactive Substances Act, which means it’s illegal to give away or sell. • There’s no penalty for possession, unless you are in prison. • Supply and production can get you up to 7 years in prison, an unlimited fine or both.
Online training http://neptune-clinical-guidance.co.uk/e-learning/
• Khat or qat (is a flowering plant native to the Horn of Africa and the Arabian Peninsula. Khat contains the alkaloid cathinone, a stimulant, which is said to cause excitement, loss of appetite, and euphoria…
Referrals + Sidney Street Service 44 Sidney Street Sheffield S1 4RH ( 0114 2721481 • Self referrals – telephone/walk in • Email: sct-ctr.start.nonopiates@nhs.net
Alcohol Services • City wide service for the people of Sheffield who use alcohol or are affected by someone else’s alcohol use. • SEAP (Single Entry Access Point) – First access point into alcohol services, providing triage assessment, advice, interventions and access to tier 3 assessment and treatment. – Delivered by trained, experienced alcohol workers with access to a multidisciplinary team.
The assessment team or Tier 3? • Comprehensive assessment of need and recommendation for treatment interventions including: Structured PSI/key working Detox (community/inpatient) Recovery Interventions Recovery support • By qualified Nurses, Social Workers and Doctors with specialist training in the area of substance misuse.
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