John is a 34 year old IV heroin user. John is homeless, estranged from his family and has limited support from other hostel residents and rough sleepers. He has been using heroin for 10 years and is currently injecting up to five £10 bags per day and frequently sharing injecting equipment. He states that he is keen to get off heroin and get his life back on track.
I would suggest the following pathway for John;
Ongoing G.P appointments for tests on blood pressure and for blood borne viruses – because John has been sharing injecting equipment, there is a possibility that he could have contracted a virus and it is important to Johns health and well being that these are either ruled out or treated appropriately.
Promote the local NHS needle exchange scheme to John – as it will take some time for the addictions services to come into place, I would suggest that John uses clean injecting equipment to minimise any further health issues that could arise from using non sterile equipment.
I would refer John to his G.P to join the methadone programme – I would expect the GP to refer John to the Primary Community Addiction Team, to help John with changing from Heroin to Methadone – giving him daily support where he lives. There remit would be testing John for Heroin in his blood, taking his blood pressure, checking his general health. All this being safe they would administer his prescribed Methadone to him.
Once John has moved completely onto the Methadone Programme, I would expect the