Cardiff and Vale UHB’s Buvidal success, a model for opioid addiction treatment
Many individuals struggle with the debilitating effects of trauma, with some self-medicating with opioids to numb emotional pain. While opioids may provide temporary relief, they can lead to addiction and further complications. Buvidal, a form of opioid substitution therapy, offers a promising new approach to treatment for opiate dependence.
Buvidal is a long-acting, injectable medication that provides a stable alternative to daily opioid substitute treatments as Buvidal can be administered monthly, reducing the frequency of dosing and improving adherence.
Addressing trauma and addiction
Buvidal can help people to feel more stable physically and psychologically, enabling them to address underlying trauma or mental health difficulties that often fuel opioid use. The medication helps reduce cravings and allows individuals to focus on recovery.
In Cardiff and the Vale UHB, a team of experts, including Consultant Psychiatrist Jan Melichar and Clinical Psychologist Lucie James, recognised the need for a comprehensive approach to trauma and mental health support for individuals on Buvidal. With the support of people with lived experience, they established the Buvidal Psychological Support Service (BPSS) to provide tailored therapy and support.
The BPSS offers extended therapy sessions, up to 32 sessions, to accommodate the diverse needs of individuals recovering from addiction, mental health and trauma. The team recognises that recovery can take a significant time, due to the often-complex needs of those affected by addiction and trauma. Additionally, the service maintains a flexible attendance policy, understanding that individuals may face challenges that prevent them from attending sessions.
Lucie said: “Often our clients are still experiencing significant challenges such as homelessness, physical health problems, financial problems and relationship problems. So, there's lots of difficulties still happening, which means that we need to be flexible. But also, there are amazing things happening as people start reclaiming their lives. If we need to rearrange a session because someone is attending an interview or moving into more stable accommodation then we think 'this is brilliant, you're moving on'. That's major progress and we need to be flexible to accommodate this.”
““I’ve truly changed on a fundamental level. Like I’m free, I’m free. I’m free to control myself and my emotions and my actions. I’ve got my freedom back. I’m not a prisoner in my own body anymore.” ”
Positive outcomes
The BPSS has demonstrated significant positive outcomes. A study of the service found that 75% of individuals who started treatment remained in treatment, and 50% of those who completed the first tier of treatment reported feeling equipped to move on and address mental health difficulties and/or process their traumatic experiences.
Many BPSS clients have reported several significant changes in their lives including a reduction in psychological distress and improvements in quality of life such as reconnecting with family, securing more stable housing and starting volunteer work or paid employment.
In Cardiff, evidence is emerging that there is a significant reduction in mental health bed admissions for BPSS clients. A cohort of 20 BPSS clients was shown to have used 40 inpatient mental health bed days in the 6 months prior to engaging with the BPSS – but in the 6-12 month period after engaging with the BPSS they had required 0 inpatient admissions.
Alongside the positive impact on the individual, this is also a significant cost benefit to the NHS. In addition to mental health support, the BPSS supports clients to address physical health issues. Many individuals on Buvidal have been able to seek necessary medical care, including cancer treatment, that they had previously avoided.
The future of the BPSS and Spread and Scale
The BPSS was initially funded in 2023 for a 2-year pilot. The BPSS has recently had confirmation of a further year's funding from Welsh Government to enable the service to continue whilst longer term plans are being explored to embed the BPSS as core business. The ongoing support of the Cardiff and Vale Mental Health Clinical Board and Area Planning Board are integral in securing the future of this service.
Last year, the team attended The Spread and Scale Academy, an immersive three-day event, led by Shaping Change, designed to scale projects across the NHS, social care, local authorities and private industry. Lucie said ‘The Spread and Scale training was invaluable in helping us bring our ideas together. It helped us to think about where we needed to go. Since the training, we’ve made some strong links with the Shaping Change and Value in Health Team.’
Spread and Scale trains teams to scale their solutions across their system and the BPSS is beginning to find that there is growing interest in implementing similar services across Wales. The team is committed to sharing their expertise and supporting others in establishing effective psychological support for those affected by opiate dependence and mental health difficulties.
Buvidal, alongside psychological support, offers a promising avenue for individuals struggling with opioid addiction, mental health difficulties and trauma. By providing a stable medication and tailored support, Buvidal can help people break free from addiction and embark on a path to healing. The BPSS in Cardiff and Vale UHB serves as a model for providing comprehensive care to individuals in need.