Rosalind Gittins

Background Management of opioid withdrawal in hospital settings is crucial to improve treatment completion and health outcomes among patients who use opioids, such as heroin. Evidence-based clinical guidelines can support responsive provision of opioid substitution therapy (OST). In England there is no standardised application of guidance for subst...

Introduction There are growing concerns about the misuse of over the counter (OTC) and prescription only medication (POM), due to the associated negative socioeconomic and health implications1. To improve care delivery, stigma needs to be addressed and more needs to be known about the perspectives of staff who are working in substance misuse servic...

Background Opioid substitution therapy (also known as ‘opioid agonist therapy’ or ‘medication treatment of opioid use disorder’) is associated with improved health and social outcomes for people who use heroin and other illicit opioids. It is typically managed in the community and is not always continued when people are admitted to hospital. This c...

UNSTRUCTURED In this viewpoint paper we explore the use of big data analytics and artificial intelligence (AI) in improving outcomes for people with opioid use disorder (OUD) and bring to the table relevant challenges that must be addressed if new technologies are to be utilised ethically, effectively and equitably. First, we explore the conceptual...

Background Opioid substitution therapy is associated with improved health and social outcomes for people who use heroin and other illicit opioids. It is typically managed in the community and is not always continued when people are admitted to hospital. This causes opioid withdrawal, discharge against medical advice, and increased costs. We are est...

Background Drug checking services (DCS) provide harm reduction support and advice to individuals based on chemical analysis of submitted substances of concern. Whilst there are currently no DCS in Scotland, community-based services are being planned in three cities. Methods In this paper, we report qualitative findings based on interviews with 43...

Drug checking services (DCS) enable individuals to voluntarily submit a small amount of a substance for analysis, providing information about the content of the substance along with tailored harm reduction support and advice. There is some evidence suggesting that DCS may lead to behaviour and system change, with impacts for people who use drugs, s...

Introduction Over the counter and prescription-only medication misuse is of concern. Little is known about the impact on friends/family who provide individuals with support. It is important to increase understanding to identify how substance misuse services (SMS) and others can better meet their needs. The aim is to explore the impact of over the c...

Background Scotland currently has the highest rates of drug-related deaths in Europe, so drug checking services are being explored due to their potential role in reducing these deaths and related harms. Drug checking services allow individuals to submit presumed psychoactive drug samples for analysis, and then receive individualised feedback and co...

Background Access to prescribed interventions and retention in treatment services are associated with improved health outcomes and reduced premature mortality rates for people living with opioid use disorder (OUD). In Leeds, transactional sex-workers frequently cycled in and out of treatment for OUD such that they never reached a level of engagemen...

Background Telemedicine-delivered medication for opioid use disorder (TMOUD) has become more prevalent during the COVID-19 pandemic, particularly in North America. This is considered a positive development as TMOUD has the potential to increase access to evidence-based treatment for a population heavily affected by the opioid crisis and consequent...

BACKGROUND Telemedicine-delivered medication for opioid use disorder (TMOUD) has become more prevalent during the COVID-19 pandemic, particularly in North America. This is considered a positive development as TMOUD has the potential to increase access to evidence-based treatment for a population heavily affected by the opioid crisis and consequent...

Across the world, the interest in point-of-care drug checking as a harm-reduction intervention is growing. This is an attempt to improve intelligence about current drug trends and reduce drug-related morbidity and mortality. In the UK, drug-related harm is increasing exponentially year after year. As such, specialist community treatment services ar...

There is substantial contemporary interest in psychedelic agents as medicines for maladies of the mind. This follows research in the 1950s and 1960s exploring the use of LSD and other psychedelics to treat a range of psychiatric illnesses as well as addictions. This research was shut down after prohibition of these drugs; however, the last decade h...

Introduction Pharmacists and pharmacy technicians have an increasingly important role in mental health community teams and within integrated care systems (ICS) as highlighted in the NHS Long Term Plan. The aim was to collate examples of good practice to establish which patient-facing activities deliver the best patient outcomes and explore how thes...

Abstract Background: A greater understanding of Over the Counter (OTC) and Prescription Only Medication (POM) misuse amongst adults accessing substance misuse services (SMS) during COVID-19 is required to identify how SMS can better meet the needs of the people who require treatment. Aim: To use a questionnaire to explore OTC/POM misuse during COVI...

There is concern regarding gender differences in problematic non-medical over the counter (OTC) and/or prescription only medication (POM) use. This issue has traditionally been considered a predominantly male and/or younger persons’ problem, but more recent transnational evidence shows that women across their life-course are increasingly and often...

Systematic Review Protocol

The recent surge in recreational (non-medical) use of nitrous oxide (N2O, also known as ‘laughing gas’) often by inhaling it from balloons, has attracted the attention of some politicians with calls to control its possession under the United Kingdom (UK) Misuse of Drugs Act 1971 (currently selling, but not possession, for recreational use is contro...

Background The impact of policing practices on the engagement of people who use drugs (PWUD) with harm reduction services is well evidenced. Although the police have traditionally taken an enforcement role in responding to drug use, it is increasingly clear that they can play an important part in multiagency delivery of harm reduction interventions...

With rising numbers of drug-related deaths in the UK and globally, exploration of interventions that seek to reduce drug-related harm is essential. Drug checking services (DCS) allow people to submit drug samples for chemical analysis and receive feedback about the sample, as well as harm reduction advice. The use of DCS is often linked to festival...

Abstract Background: Concerns about the misuse of over the counter (OTC) and prescription only medication (POM) are due to their impact upon physical/mental wellbeing, drug interactions and drug-related deaths. Improving an understanding of the pattern of use by people accessing specialist substance misuse services (SMSs) should enable improvements...

Pharmacy has the ability to better support people who use substances, while simultaneously acting sustainably.

Introduction Over the Counter (OTC) and Prescription Only Medication (POM) are misused by people who access substance misuse services (SMS). Harms include impact upon physical/mental wellbeing and potentially fatal overdoses, with concerns growing amongst healthcare professionals, commissioners and the general public (1). SMS must respond to increa...

Introduction An improved understanding of Over the Counter (OTC) and Prescription Only Medication (POM) misuse by people who access substance misuse services (SMS) is essential so that appropriate treatment interventions can be provided. There is growing awareness and concerns about this issue, especially during COVID-19; however, there is a paucit...

We describe a case report where buprenorphine was successfully used for the management of kratom (Mitragyna speciosa) dependency during the Covid-19 pandemic in a specialist community substance misuse treatment service. The individual had a notable iatrogenic dependency on oral over the counter and prescribed opioid medication. She resorted to usin...

Background Methadone use for the management of opioid dependency during pregnancy is commonplace. Methadone levels are altered during pregnancy due to changes in maternal physiology. Despite this, a paucity of data exist regarding the most appropriate optimal dosing regimens during pregnancy. Methods This study applied a pharmacokinetic modeling a...

Introduction There is a growing concern about the misuse of over the counter (OTC) and prescription only medication (POM) because of the impact on physical and mental health, drug interactions, overdoses and drug-related deaths. These medicines include opioid analgesics, anxiolytics such as pregabalin and diazepam and antidepressants. This protocol...

Providing currently prohibited drugs through pharmacists sounds like a radical idea, but it could be a way of taking these substances out of the hands of crime groups and improving prospects for users.

(1) Introduction: Drug-related deaths in the UK are at concerning high levels. The unknown content and purity of illicit substances can cause unpredictable adverse effects and thus a public health risk with no sign of abating. On-site drug checking is a public health strategy that has previously been implemented, predominantly in festival settings,...

Drug checking services have been operating worldwide as a harm reduction tool in places like festivals and nightclubs. A systematic review and netnographic analysis were conducted to explore the public’s perception of drug checking. Although public perceptions of drug checking had not been previously evaluated in the literature, some positive and n...

Objective: This survey aimed to explore knowledge and experience on novel psychoactive substances (NPS) of healthcare professionals (HCPs). The study also aimed to assess how HCPs would like to improve their knowledge of NPS. Methods: Seventy paper questionnaires were disseminated in 2017 within continuing education events to pharmacists, nurses an...

There is growing recognition of the potential utility of medical cannabis as a harm reduction intervention. Although used for this indication in other countries, there is an absence of UK clinical guidelines that supports such an approach. We administered a short survey to gain a better understanding of the potential role of medical cannabis by 39...

Background The use of oral methadone in opioid substitution treatment (OST) for the management of opioid use disorder is established clinical practice. Confounding treatment is the increased risks of contracting Mycobacterium tuberculosis, the mainstay treatment of which incorporates the potent CYP 2B6 inducer rifampicin. Methods This study applie...

Substance misuse services need to meet the growing demand and needs of individuals using new psychoactive substances (NPS). A review of the literature identified a paucity of research regarding NPS use by these individuals and UK guidelines outline the need for locally tailored strategies. The purpose of this qualitative study was to identify and e...

Objective: To compare the characteristics of people with fibromyalgia (FM) with those with other forms of nonmalignant chronic pain. Design: A prospective cohort study conducted in a chronic pain management clinic within an academic medical center. Setting. : Many symptoms of the chronic pain syndrome FM are common to other pain or musculoskel...