Background to Project:

In May 2019 ProLAR the Norwegian drug user network organised an advisory board meeting with drug user organisation from a range of European countries and the Swedish pharmaceutical company Camurus. ProLAR is a member of EuroNPUD and their Executive Director, Ronny Bjørnestad is the Vice-Chair of EuroNPUD and EuroNPUD were happy to contribute to and back the development of the advisory board meeting. The Danish drug user network, Brugerforeningen hosted the meeting in Copenhagen.

At the advisory board meeting scientific and clinical features of all long acting formulations in development for treatment of opioid dependence was discussed in addition to drug user organisers sharing their experiences of the effects of opioid dependence treatment with medications and also their concerns about the regretfully often paternalistic and overly intrusive nature of too much medication treatment.

Based on these discussions, a joint declaration that was endorsed by EuroNPUD and the country drug user groups and Camurus was developed.

In 2001, the UK drug user group Respect Drug Users Union worked with a team of researchers to undertake a study looking into the barriers to access and retention in drug treatment services. The study identified five key reasons why people who are dependent on opioids seek help:

· Dependence

· Attitudes to the means of funding opioid dependence

· Effects on relationships

· Effects on health

· Effects on self-image

Half of people dependent on opioids acknowledge they have a problem but don’t seek help. The biggest barrier is fear of judgement from doctors and other healthcare professionals. People complain about prolonged assessment procedures, inflexible treatment regimes, negative attitudes from clinicians, fear of confidentiality being breached, and the imposition of ‘one-size-fits-all” models of treatment, underdosing, and overly intrusive supervision and controls over dispensing.  Drug users describe treatment workers as the “methadone police” reflecting the breakdown of trust in treatment relationship, which leads to lower numbers in treatment and higher drug related deaths.

In light of these concerns, Camurus provided EuroNPUD with an unrestricted educational grant to support the development of OAT Opioid Agonist Treatment. The project will drive up access to high quality OAT that respects choice of OAT medications and supports people who use drugs to be active and informed partners in treatment.

The project has five stages:

1) Appoint Project Manager and form Project Team
2) Personal Testimony Posters will be developed to promote the value of OAT to the general population. The model to be agreed and commissioned by Project Team.

3) Technical Briefing on OAT Opioid Agonist Treatment will be developed as an advocacy toolkit for drug user activists. It will describe the different OAT pharmacotherapies and their role and values, good practice with regards to assessment, treatment initiation, dispensing and review, and standards in meaningful participation / client centred care.

4) Country consultations – Three facilitated meeting will be conducted with key stakeholders in OAT in the three target counties – UK, Sweden and Germany. The participants will look at the quality standards in the technical briefing and compare this with their country context. The partners will look for opportunities to promote the standards from the Technical Briefing in the country with key stakeholders.

5) Webinar to disseminate findings from the project. Zoom webinar format and provides recording as an enduring resource.

OAT ➫ Opioid Agonist Treatment Project 

The OAT ➫ Opioid Agonist Treatment Project is based on the collaboration between EuroNPUD, the donor / pharmaceutical company Camurus and the three pilot countries: Germany, Sweden and the United Kingdom (UK). The project is managedby Christos Anastasiou from PeerNUPS.

OAT Client Guide

One of the key elements of this project was the development of the OAT Client Guide called ..>> OAT – We are in it together! This is a guide about treatment for opioid dependence from people who have lived it. The OAT Client Guide consists of a technical briefing on opioid dependence, OAT medication and the process of OAT assessment, treatment initiation, dispensing, supervision and review. It also includes standards in meaningful participation and client-centred care. The document further includes a troubleshooting section that helps address key problems that may arise in delivering an OAT care plan. With this project, EuroNPUD sought to empower people with opioid dependence to raise their knowledge about the treatment system,treatment options and the rights of people in drug treatment. This supports peers to talk in an informed and educated way when advocating for their rights.

𝐂𝐥𝐢𝐜𝐤 / 𝐡𝐨𝐥𝐝 𝐭𝐡𝐞 𝐢𝐦𝐚𝐠𝐞 𝐭𝐨 𝐨𝐩𝐞𝐧 〔 𝐝𝐨𝐰𝐧𝐥𝐨𝐚𝐝 〕 𝐭𝐡𝐞 𝐏𝐃𝐅 𝐝𝐨𝐜𝐮𝐦𝐞𝐧𝐭

𝔸𝕝𝕝 𝕒𝕓𝕠𝕦𝕥 𝕥𝕣𝕖𝕒𝕥𝕞𝕖𝕟𝕥 𝕗𝕠𝕣 𝕠𝕡𝕚𝕠𝕚𝕕 𝕕𝕖𝕡𝕖𝕟𝕕𝕖𝕟𝕔𝕖 𝕗𝕣𝕠𝕞 𝕡𝕖𝕠𝕡𝕝𝕖 𝕨𝕙𝕠 𝕙𝕒𝕧𝕖

𝕝𝕚𝕧𝕖𝕕 𝕚𝕥

𝐂𝐥𝐢𝐜𝐤 / 𝐡𝐨𝐥𝐝 𝐭𝐡𝐞 𝐢𝐦𝐚𝐠𝐞 𝐭𝐨 𝐨𝐩𝐞𝐧 𝐭𝐡𝐞 𝐟𝐮𝐥𝐥 𝐏𝐃𝐅 𝐝𝐨𝐜𝐮𝐦𝐞𝐧𝐭

The OAT project also includes country consultations with peer and professional stakeholders in three pilot countries. Pilot countries are in different stages with regard to this part of the project, which corresponds with specific country contexts. Germany has already completed the consultation, whereas the UK and Sweden will conduct it this year.

OAT Opioid Agonist Treatment Project has proved to be a great success and is due to continue in 2021. Talks are currently underway about translating the OAT leaflet into Norwegian and Greek language, while EuroNPUD hopes to pursue OAT project also in other European states. Furthermore, EuroNPUD will deliver a webinar about the OAT project in March as part of the series on Peer Work.