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PY365 Substance Misuse > Public Health and harm reduction 2 > Flashcards

Public Health and harm reduction 2 Flashcards

1
Q

Give examples of pharmacy harm reduction strategies

A
  1. needle exchange
  2. supervised consumption
  3. dispensing
  4. health and well being advice
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2
Q

outline the harm reduction advice for injecting drugs

A
  1. never share any injecting equipment
  2. never reuse a needle
  3. visit your local needle exchange
  4. injecting any drug is an extremely high risk practice- avoid
  5. always dispose of equipment safely- sharps bin
  6. use with other people that you know
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3
Q

outline the harm reduction advice for snorting drugs

A
  1. alternate nostrils
  2. rinse nose with water before and after
  3. if you get nosebleeds or headaches, using too much
  4. use a clean straw
  5. don’t share rolled bank notes or straws
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4
Q

outline the harm reduction advice for swallowing drugs

A
  1. break pills into half or quarter and wait up to 3 hours before redosing
  2. drug has to pass through digestive system, so this method is less intense but more long lasting than others
  3. eat a light meal a few hours before to reduce stomach aches, nausea and vomiting
  4. regular use can lead to stomach ulcers
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5
Q

outline the harm reduction advice for smoking drugs

A
  1. don’t hold breath after inhaling, this causes more damage to the lungs
  2. generally results in shorter, more intense experience
  3. regular smoking can cause respiratory problems
  4. choose a non toxic pipe and avoid plastic or metal
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6
Q

what can injection drug use lead to

A

spread of HIV and other blood borne infections such as hepatitis B and C

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7
Q

why were needle exchange programs set up

A

set up in response to the sharp increase in the spread of BBVs

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8
Q

what is the aim of needle exchange programmes

A

to provide drug users with the appropriate help and support to remain healthy until they are ready and willing to stop injecting and achieve drug free life

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9
Q

what are the objectives of needle exchange programmes

A
  1. promote safer injecting practises
  2. reduce risk of sharing and high risk injecting behaviour
  3. provide sterile injecting equipment
  4. ensure safe disposal of used equipment
  5. increase access to pharmacy- provide and reinforce harm reduction messages
  6. sign post to services
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10
Q

which groups are likely to use needle exchange

A
  • not just for people who inject heroin, cocaine or amphetamine
  • also for performance or image enhancing drugs such as anabolic steroids
  • psychoactive compounds, chemicals, plants or medicine
  • ketamine
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11
Q

what does the NICE public health guidance say on what pharmacists can supply

A

a pharmacist may supply specified drug paraphernalia to illicit drug users

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12
Q

how what is required for needle exchange to take place in a pharmacy

A
  1. all staff need to be trained on the scheme
  2. need to be Hepatitis B vaccinated
  3. specific SOP/protocol in place
  4. area of pharmacy for storage
  5. record keeping
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13
Q

what does the client require from the needle exchange program

A
  1. need to know how to access the scheme
  2. need privacy and confidentiality
  3. need clean, full packs to take quickly and easily
  4. need to respect pharmacy environments
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14
Q

describe the practicalities process

A
  1. SMS run training and authorise pharmacy
  2. pharmacy orders stock from SMS
  3. PCO collects sharps bins
  4. collegues don’t touch returned sharps
  5. client comes in, places sharps in bin and picks up a new pack
  6. payment- locally commissioned service
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15
Q

describe the steps of opiate substitution therapy

A
  1. enrolment and assessment
  2. titration at SMS clinic
  3. maintenance and eventual withdrawal
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16
Q

what is involved in the enrolment and assessment of opiate substitution therapy

A
  1. once they have made an informed decision about treatment, then:
    - pharmacist will get them to fill the relevant referral forms to enrol them at drug treatment programmes
  2. they receive an appointment for formal assessment which covers
    - drug use (past and present)
    - health (mental and physical)
    - employment
    - social history
17
Q

what is the first aim of treatment of addiction

A

to control drug use with substitute prescribing and support that will lead to a stable lifestyle

18
Q

what does treatment choice of addiction depend on

A

depends on patient factors and their level of illicit drug use

19
Q

what is the dose of methadone and buprenorphine used in opioid replacement

A

dose is titrated until symptoms of withdrawal are prevented
- SMS clinics

20
Q

what is the overall outcome of methadone and buprenorphine opioid replacement

A

abstinence from both illicit and prescribed medication

21
Q

how does supervised consumption occur

A
  1. agreement is made with SMS, client and pharmacist for supervised consumption
  2. supervision is taken over by community pharmacy
22
Q

what is required in order for a community pharmacist to supervise consumption

A
  1. must have a private area
    2.have sufficient capacity for new patients
  2. ability to confirm prescription and prescriber genuine
  3. understanding of SMS service and client needs
    - referral to other healthcare professionals when appropriate
  4. undertake training
23
Q

what is the benefit of community pharmacies being involved in harm reduction

A
  1. can legally dispense CD2 medication
  2. convenience for client- increases compliance
  3. long opening hours
  4. healthcare professional on high street
  5. cost effective
24
Q

what is an FP10 MDA

A

instalment prescribing for controlled drugs used in substance misuse treatment

25
Q

what is the shared care policy

A

sharing information between the prescriber, the patient and pharmacist
- eg. when patient misses scheduled pick ups or supervised consumption
- concerns about patients health or wellbeing
- patient attends intoxicated

26
Q

when should you disclose confidential information

A

should take necessary steps to satisfy yourself that any disclosure sought is appropriate and meets the legal requirements covering confidentiality

PY365 Substance Misuse (10 decks)

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