I have had a diverse, portfolio career, working across academia, the NHS and industry, including setting up a medical start up and being a HEFCE “New Blood” Clinical Senior Lecturer. I have developed numerous protocols, including the Buprenorphine Front-loading “Detox-in-a-Box” detoxification protocol – extensively used in the UK – and the Buvidal (long acting injectable Buprenorphine) rapid 24/96 protocol. In 2020, due to Covid-19, I led a funding bid to Welsh Government asking for country wide funding of Buvidal. This was fully funded – to date, I have given several hundred injections to a diverse range of patients.
Benefits of 24/96 Buvidal assisted recovery in South Wales – Rapid service development due to enhanced country wide Covid-19 funding of this long acting buprenorphine formulation
Introduction: Buvidal – long-acting Buprenorphine – provides allostatic craving and anxiety reducing benefits compared to oral buprenorphine. In part following a Covid-19 request by the authors, Welsh Government funded Buvidal to a wide range of patients, from the complex homeless to those stable on oral buprenorphine. Methods: We recruited from our Newport and Cardiff services as part of a service evaluation. We developed novel approaches to improve the service across patients’ varied biopsychosocial multi-morbid needs in the context of Covid-19.Results: 90 are in treatment at present. We switched from the slow four week titration to everyone having 24mg weekly first week (~= 16mg oral buprenorphine). In the second week, the majority received 96mg monthly, then monthly thereafter – the 24/96 model. Most were on a stable dose (96mg or 128mg) by month three. There were no significant differences in side effects compared to the original slower protocol. Psychologically, many patients reported feeling less anxious, with little craving, little on-top opioid use and diminishing use of other illicit substances, with evidence emerging regarding the necessity for appropriate psychosocial support/ interventions.
Preliminary Conclusions: It was refreshing to introduce a novel long acting version of Buprenorphine that appeared, for many patients, to move them into Recovery in a manner they had not been able to achieve to date. Speeding up getting them onto Buvidal due to Covid-19 did not cause any issues or problems – indeed it was beneficial. Psychologically, we continue to develop pathways to ensure robust holistic support throughout their recovery journeys.