Supervised Injecting Clinic - SLaM National Services

Supervised Injecting Clinic
Location: Maudsley Hospital
Mode: Outpatient
75% of our patients significantly
reduced their use of street heroin,
compared to 25% of people who
received optimised oral methadone
treatment.
Our supervised clinic provides intensive treatment for people
with a severe heroin addiction, where previous orthodox
drug treatment has failed.
People are prescribed injectable heroin (diamorphine)
or methadone, which is administered at the clinic under
supervision. Supplementary oral medication, can be provided
between injecting sessions to prevent opiate withdrawal,
or if the person is unable to attend a session.
The clinic is open every day and all injectable doses are
supervised, so there is no potential for abuse or transference
into the community. Our keyworkers, doctors and
psychologists provide people with physical, psychological
and social support, to address the underlying causes of
addiction, and any related health issues. People typically
attend the clinic up to twice daily, seven days a week.
Criteria
Eligibility
• 21+ years
• Male or female
• Opiate dependent
• Six or more year history of injecting heroin
• Daily injecting heroin use in the past six months, despite already
receiving orthodox treatment
• Receiving methadone or buprenorphine treatment for at least
two years, and continuously for at least the last six months
• Ability and willingness to attend the clinic twice a day, seven
days a week
Exclusion
• Significant medical or psychiatric condition
• Severe alcohol dependence
• Benzodiazepine misuse in an erratic manner
• Pregnancy
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Interventions which may be provided
• Supervised, injectable heroin treatment
• Injectable methadone maintenance treatment
• Supplementary oral maintenance co-treatment
• Health screening
• BBV vaccination programme
• Regular keyworker sessions
• Medical reviews
The information and prices listed in this document
are valid from April 2012 to March 2013.
Outcomes
• Stabilised
• Ceased or reduced use of street heroin
• Improved health
• Improved psychological well-being
• Ceased or reduced drug-related criminal behaviour
(if present at entry)
• Moved further away from previous, entrenched street heroin
use, other street drug use, hazardous or harmful alcohol
or sedative drug use
• Improvement in psychological well-being
• Resumed family involvement and responsibilities
• Returned or commencement to work or training

Care option Description Cost Unit Code
Outpatient
Supervised
injectable opiate
maintenance
programme
We offer intensive treatment for severe heroin addiction where
orthodox drug treatment has failed. It is suitable for people who
have been receiving buprenorphine treatment for at least two years,
without improvement. Treatment consists of injectable heroin
maintenance, under direct supervision up to twice daily, in a
medically supervised clinic. The cost of this service for commissioners
is price on application for 12 months of treatment. This cost is
equivalent to the normal annual cost if you were providing
supervised prescribing in your local community service.
POA
Per annum,
or part thereof
92539
Referrals are accepted from: Contacts: Address:
NHS GPs
Statutory and non-statutory
specialist drug agencies
Dr James Bell, Consultant Physician
Professor John Strang, Consultant Psychiatrist
Marina Frederick, Operational Manager
Supervised Injecting Clinic
Acute Assessment Unit - Annex
Maudsley Hospital
Denmark Hill
London SE5 8AZ
Tel: 020 3228 1900/5135
Fax: 020 3228 5138
Email: addictionsreferrals@slam.nhs.uk