A long-acting opiate replacement therapy piloted during the pandemic amid concerns about prison staff shortages and to reduce daily pharmacy visits is to be rolled out across Scotland.

A new report found the treatment that was brought in as a contingency measure in prisons shortly after covid-19 hit has helped reduce prisoners’ cravings and improve their quality of life.

Normally opiate addiction among prisoners is treated with a replacement therapy – most commonly methadone – that needs to be taken every day under the supervision of at least two NHS staff members. Some prisoners are prescribed oral buprenorphine products and although an effective medicine for treating addiction, it can come with other problems including bullying and coercion if prisoners use it as currency.

Buvidal though – which is a form of buprenorphine – is a replacement therapy that is longer acting and can be given out monthly or weekly through a slow-release injection, rather than daily oral doses dispensed by staff.

It was brought in partly as a way of reducing contact between staff and prisoners to mitigate against the spread of covid-19, but also with the hope that less time spent taking medication would leave more time for individuals to focus on other forms of recovery.

Research carried out by the Scottish government’s Health and Social Care Analysis Hub found that switching to Buvidal has improved prisoners’ wellbeing and reduced ‘drug-seeking behaviour’.

In 2020 £1.9m was allocated to support people in prison on prescribed daily opiate substitution treatment to switch to Buvidal.

Drugs Policy Minister Angela Constance said: “This report shows very encouraging feedback on the use of Buvidal and I have already announced the allocation of £4m for the current financial year, so this treatment option can be made available more widely in prisons and in the wider community.

“During the pilot this opioid substitute resulted in positive changes in people’s emotional wellbeing, leading to positive lifestyle changes, such as people re-engaging with purposeful activities. This can enhance recovery by relieving anxiety, reducing stress, and increasing social interactions, while also fostering feelings of hope and optimism.

The Almond Valley representative added: “The report also says the medicine appears to alleviate cravings and reduce drug seeking behaviour.

“This pilot has been a good experience for almost everyone involved - support continuity of care, while reducing the need for daily contact and reducing pressure on our front-line prison officers and NHS staff.”

National Prisons Pharmacy Adviser for Healthcare Improvement Scotland Tom Byrne said he is delighted government has recognised the benefits of Buvidal:

“The decision to include Buvidal as a treatment choice has been widely welcomed by patients, clinicians and the Scottish Prison Service. Retention of patients on this treatment has been very high, reflecting the improvements in health and quality of life experienced by those for whom this treatment is appropriate. 

“We believe that proposals to extend access to this treatment beyond prisons and to the wider community will be a significant development in supporting delivery of the medicines assisted treatment standards, patient centred care and contribute to a reduction in drug related deaths.”

Read more: Call to extend overdose kits to community pharmacies; Prison pilot drug scheme success during pandemic; Third sector promised part to play in drugs fight

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