The LTMP team at Spittal Street is made up of a pharmacy prescriber, two nurses and a health care practitioner focusing on therapeutic input. This team coordinates the treatment and care of all patients currently being prescribed opiate substitution treatment (OST) within the Harm Reduction Team.
Criteria for the programme
The criteria for patients being accepted for this intensive programme is complex, but simply put, it includes people who inject drugs (PWID) combined with other co-morbidities and need additional support. Other criteria could include:
- to be registered with a local/Lothian GP
- PWID, often in high risk places, anatomically (for example injecting into femoral vein/s or neck injecting)
- using multiple illicit substances/polysubstance use
- drinking alcohol at harmful levels
- mental health issues
- homelessness
- selling sex
- have a history of non-engagement with other prescribing services and regularly need retitrating on opiate substitution medication
- Blood-borne virus risk.
Referral routes
- From patients GP
- From one of the Recovery Hubs
- From EdMAC – Edinburgh Medicated Assisted Clinic
Once someone is referred to us, the team will discuss their needs, decide if they meet our criteria and if we have space, communicate with their current prescriber or GP regarding the outcome of the referral and moving forward.
Our approach
The LTMP team use a collaborative approach between the patient and clinic staff where individual care plans are designed to meet their specific needs.
They are offered the most appropriate OST that is therapeutically beneficial in line with MAT standards. Currently, this includes methadone or buprenorphine (both oral and subcutaneously). Depending on the complexity of the patients’ needs and level of stability, they will be invited to attend the service in one of three ways:
- Attend for dispensing 4 days a week with pharmacy pick-ups on Wednesday and weekends. With this style of attendance patients are asked to attend between 1230 and 1630 Monday, Tuesday, Thursday and Friday. On presentation they will be dispensed their appropriate medication and staff will enquire as to their current drug use and wellbeing. They will be offered appointments with a key worker, our psychiatrist, our dentist, welfare adviser, our occupational therapist or to attend group work. The objective is to stabilise the patient on their medication, move them away from illicit drug use as well as improve their general wellbeing introducing healthier structures and routines.
- If the patient is stable they may be asked to attend once a week or once a fortnight to pick up a prescription for their medication and then present at a local pharmacy to be dispensed appropriately.
- If the patient is suitable for injectable forms of buprenorphine (Buvidal), these can be administered weekly or monthly.
Other services
Other services within Harm Reduction Team that patients can access:
- A Psychiatrist in the team two days per week
- An Occupational Therapist who works over four days
- A multidisciplinary team containing nurses ( adult and mental health) a pharmacist, staff with lived experience, support/key workers, staff with Health Promotion and Health Education backgrounds
- Specialist wound care nurses with a wound clinic on Thursday mornings
- A dental service in the building three days per week
- A women’s sexual health clinic in the building one day a week
For any enquiries, please phone reception on 0131 537 8300
