The Drugs Research Network Scotland (DRNS), in collaboration with colleagues from NHS Lanarkshire, hosted a virtual knowledge exchange event exploring palliative and end-of-life care for people who use drugs. The two hour session shared current practice and experiences from teams within Lanarkshire as well as the sociological perspective from colleagues at Manchester Metropolitan University.
The event took place on the 30th September 2021 and included a series of presentations from the Community Addiction Team, Palliative Care Consultants and Researchers working in the field. Attendees were able to contribute to a group discussion and ask questions on the experiences of the teams working in Lanarkshire. The event was fully subscribed with 63 individuals attending, including NHS addictions teams, pharmacists and third sector service providers. This report provides a summary of the presentations, access to slides, a recording of the event, as well as some key points highlighted during group discussion.
Presentations
The presentations were recorded, with the recording available here.
Welcome & Introduction: Setting the Scene: Dr Edmund Stewart, Addiction GP, NHS Lanarkshire
Ed provided an overview of the background information relating to Palliative care and addictions within NHS Lanarkshire. He explained the demographic of patients they treat, the need for ongoing linkage with Palliative Care colleagues and the development of local guidelines for End of Life Care for patients with drug or alcohol problems. Access his slides for more detail:
Palliative Medicine for Addiction Specialists: Dr Susan Cook, Palliative Medical Consultant, NHS Lanarkshire
Susan presented information on the current practice delivered to patients within her service. This included information on which opioids are used and why, considerations for the use of methadone and buprenorphine in palliative care, as well as experiences of treating people who use drugs in a palliative care setting. Access her slides here:
Palliative care and substance use: the social care perspective: Dr Sam Wright, Manchester Metropolitan University
Sam provided insight into research on the considerations made by social care colleagues when working with people who use drugs in end of life care settings. She discussed the main research findings which included:
- Patients are often individuals with multiple complex needs
- Complex symptom and pain management is required
- Need to counter stigma and stereotyping
- Non-judgemental, empathetic care is essential
- Good communication is critical
Access her slides here:
Patient Case Study: Liz Marr, Senior Clinical Pharmacist, NHS Lanarkshire Addictions
Liz presented on one case study example the team in Lanarkshire supported. Liz ran through the patients history and timeline, and provided insight into the ongoing treatment. More information here:
Palliative Care and Substance Misuse – Development of Guidance: Linda Johnstone, Macmillan Lead Pharmacist, Palliative Care, NHS Lanarkshire
Unfortunately, Linda had to unexpectedly miss our event, however Susan was able to present on her behalf. Linda’s presentation provided an overview of the guidelines currently under development and review within NHS Lanarkshire. These guidelines aim to aid the delivery of palliative care to people with substance use and to improve access to palliative care services. Access her full presentation and preliminary guidelines here:
Discussion
During the event, several comments and questions were raised which are summarised here: