41 patients were entered into
our outcome study aged between 23 and 62yrs old. They represented over 10% of all the Class A patients being treated in Kingston
Upon Thames. 31 completed nine months in the study at the end of April 2010.
35% were looking for work, and 10%
were actually working.
There was only
one unplanned discharge in over three years and he quickly requested to return (The National Treatment Agency is pleased if patients
can be retained in treatment for even three months)
- 97% stopped injecting
- 33 % stopped ALL opiates (including Methadone /Subutex)
- 94% made Excellent
to Good overall progress
Anecdotally nearly all of these patients caused practice staff much less
- Police reported that Kingston was the
safest London Borough in 2008; with a large drop in the Crime rate;
- Burglary by 3% Criminal damage
by 6% Theft & Violence by 10%.
- In the town centre near where our practice is situated, Criminal damage dropped by 17% Violence against person
by 22% and Theft by 24%
Two moved out of our area, one left then requested to return.
One tragically died while self-injecting another died of a heart attack unrelated to drugs another patient tragically died
of heart failure having completely conquered a thirty year opiate problem with carecreds. At the start most were on Methadone
but 34% were using street drugs on top with 17% injecting. 34% had additional alcohol problems, 45% used Cannabis and 86%
smoked tobacco. 70% were depressed and only 10% did any exercise. 55% had housing problems and 72% were stressed by shortage
of money. Many had serious difficulties reading and writing.
Analysis of the results of those who have spent at least three months in the study revealed a large (30%) increase in overall
CareCred earnings after just this brief time. The Carecred score is, in itself, a measure of healthcare improvement. At the
start 13/31 (41.9%) were earning 14 or more CareCreds i.e. half of those available to them. After three months 26/31 (83.9%)
had reached this target. This is statistically highly significant p=0.00075.
Results indicated that giving earnings-related vouchers is the most effective strategy; 82% of this group show improvement in their Carecred scores
as opposed to only 54% in Flat rate earners. The latter were no better than the Control (no voucher) group.
Looking at the
reduction of drug addiction. After nine months using ECBC 83.9% (26/31) were testing free of all Street Class A drugs
on random urine testing. Furthermore 33.3% (10/31) had
come off all opiates i.e. including Methadone and Subutex.
This is a highly significant result as all patients were opiate users before. Neverthe less we feel it is important to maintain
surveillance for as long as possible after patients become street clean as a 25% relapse rate has been reported in other
studies and believe that he long-term retention of patients using ECBC will enable us to assess relapse rates better.
Recent government figures claim that £1 Billion a year is spent on treating Class A addiction (and a further £13.9
Billion on imprisonment for drug-linked crime!). Overall 165,000 patients (?episodes) were treated annually but only 15000
were free of dependency on discharge. i.e. a success rate of 9% at a cost of £66,700 per success. ECBC by contrast has
got 33.3% of its patients drug-free after only nine months for less than £778 per success i.e. a hundredth of the
Despite this, unfortunately Kingston SPAD (Strategic Partnership for
Drugs & Alcohol), who had already extended our funding till Easter 2010, were not be able to continue after this date because
of Credit Crunch cuts to their budget. Since stopping three patients who were doing well continued to complete home detox. Two
others who were not benefitting so much become more unstable and perhaps not coincidentally the local figures for theft
have begun to rise.