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‘OST is an extremely valuable tool
in
the fight against drug addiction, and
we are clear that the evidence base
supports its part in our treatment
system,’ says Adfam’s
Medications in
drug treatment: tackling the risks to
children
report (
DDN
, May, page 4).
‘However,’ it adds, ‘we also must
recognise that the drugs used –
especially methadone – are toxic,
powerful and a clear danger to children
when stored or used incorrectly by
their parents and carers.’
Alongside interviews and a review
of existing guidance and research, the
report studies 20 serious case reviews
from the last decade involving the
ingestion of OST medication by
children, and concludes that children’s
safety is not being prioritised by
treatment professionals. It calls for
better training and improved national
data collection, and says that far too
little is even being learned from the
findings of the serious case reviews
themselves.
‘I do think that’s true,’ says Sue
Bandcroft, who retired from her post
as substance misuse manager for
Bristol City Council last month and
was involved in a serious case review
in the city. ‘There’s always – and
always should be – a lot of local
learning, but that’s not always brought
together and, because there’s no
requirement to publish them in full,
you often get reports that are very
redacted, so it can be quite hard to
find the messages.’
One of the consequences of this is
an ongoing wide variation in practice
across the country, says Birmingham
GP and drug policy advocate Dr
Judith Yates. ‘What we’re doing varies
from place to place depending on
whether we’ve had any of these
tragedies in our area or not, and it
seems a bit poor that we seem to be
learning after each individual tragedy
rather than having any central collation
of it all. It needs to be national
guidance, rather than waiting for some
poor child to die and then learning
from that, which is what we did here.’
A child whose family her practice
was involved with died from an
accidental ingestion in 2008, since
which time ‘we’ve had safe storage
boxes given to everybody,’ she says.
‘Some services around the country do
that, and some don’t.’
A new study as part of the
Keeping
children safe at home
project is now
hoping to go some way to addressing
these variations in practice. A multi-
centre case control study of all
children aged up to four who go to
A&E as a result of poisoning – not just
by OST – it aims to be largest ever to
look at the modifiable risk factors for
poisoning in young children, with its
findings hopefully used to develop
better prevention strategies.
As well as better data collection
and improved analysis of serious case
reviews, however, Adfam’s report is
also calling for a ‘re-emphasis’ of the
importance of safeguarding children
when making decisions about OST in
line with existing NICE guidance, and
for improved training for drug workers,
GPs, pharmacies, social workers and
others to make sure they’re fully on
top of child protection issues.
‘What looking at case reports
clearly indicates again and again is
just the importance of coordination
and cooperation and communication
between all the different agencies,’
says Yates. ‘So it’s not only drug
workers who should be looking at
where the methadone – and not just
methadone, but all medication – is
being stored in the house, but health
visitors and everyone else. They look
at stair gates and all the other hazards
in the house, and they need to be
particularly aware when parents are on
particularly dangerous medication.
When social workers make home visits
they should be asking “where’s the
medication? Show me”.’
In terms of challenging the parents
they come into contact with, however,
Adfam’s recent report on the ingestion of drug treatment medications by children
makes worrying reading.
DDN
looks at what could be done to reduce the risks
News focus |
Analysis
SAVE THE CHILDREN
6 |
drinkanddrugsnews
| June 2014
www.drinkanddrugsnews.com
‘OST is an extremely valuable
tool in the fight against drug
addiction... However, we also
must recognise that the drugs
used – especially methadone –
are toxic, powerful and a clear
danger to children when stored
or used incorrectly by their
parents and carers.’
ADFAM