4. Reasons for prescriptions of benzodiazepines to Oldham patients*

5. Prescribing period for patients (number of weeks between first and latest prescription)

8. The ADS Benzodiazepine Withdrawal Service I am extremely proud of the Benzo service in Oldham and look forward to the day when, with appropriate investment, we will be able to deliver essential services like this one in all the areas in which we operate Rhona Bradley, Chief Executive ADS

9. ADS ADS : Registered Charity Operating since 1973 Turnover of over £9.5m 100 projects/services 300 staff 250 volunteers Operates from 30 permanent and outreach centres Footprint in the North of England and Midlands ADS values are: Flexible and Responsive Professional Innovative Empathy Respect

10. Oldham TRANX Oldham Tranx was formed 22 years ago, by Mike Levin's, a former CPN Nurse. It meets each Monday,11.00am-1.00pm The Group listens to each others concerns, advice is offered Members are at all stages of recovery, so pass on their knowledge to others. Very friendly and constructive advice is given. Prof. C.H.Ashtons Withdrawal Protocol is used for reference and the BNF. For complex withdrawals, Barry can contact Prof.Ashton direct and she kindly responds. Members are given each others contact details, for further support. Withdrawal is not 9 to 5 only. Had visitors from Australia, Canada, USA, Ireland and from outside our catchment area of Oldham.ie. Staffs, Liverpool, Huddersfield, Blackburn. There are no similar services in their immediate area. It arranges guest speakers from the Medical Profession, DWP and Oldham PCT and MPs. Oldham Tranx is all voluntary, No-one is paid. The funding is maintained through small local grants, Donations and bequests. No funding from National or Local Authorities. It advertises in the local free Newspaper, Local and National articles, referrals from GPs and Mental Health Services. In addition our details are on various websites. It liaises with Addiction Dependency Solutions, Oldham. ADS won the contract awarded by Oldham PCT, to supply the only NHS funded Benzodiazepine Withdrawal Service for legally addicted patients. This has resulted in 2 Benzo nurses working out of GPs Surgeries, in the Oldham area, in order to withdraw patients safely and at the patients own pace. They use complimentary medicine, including acupuncture, relaxation, CBT, head massage and other techniques. Oldham Tranx members have access to all these. ADS have had the humility to learn from Tranx members and sit in on discussions, to listen and learn.

11. The Benzo Service A decade of evolution

12. Aims and Values Proactive engagement Proactive intervention Long term wellbeing Save the NHS money in the future Creates speed of access Supports GPs with resources and time Expertise Clean up GP surgerys

13. ADS approach Approach GP surgerys Specialist worker given access to GP data Target medical history Formulates a targeted client list Letters sent out. Access points identified Benzo clinic set up for GP surgery. Reduction plan agreed Worker writes the new weekly prescription, doctor signs it off Duration:16 weeks Aftercare counselling and acupuncture. Address underlying reasons for medication use Once stabilised – we move on; A targeted task force

14. Key points Many letters sometime required. Very proactive ADS works on the basis of reducing a clients medication by 1mg per month over 16 weeks before a break in treatment or discharge Each person is different (some people may reduce quicker) Counselling and holistic care provided alongside reduction plan as part of the Benzo clinic Support network of the Oldham Tranx Group vital to treatment 13 GPs at any one time. Identified as the threshold of one specialist worker

15. Key findings Reduction regimes follow the Ashton protocol and are tailored to individual need During 2011-12 the service worked with 120 clients The drugs most commonly identified at assessment were diazepam, zopiclone and temazepam 61% of discharge clients were in treatment for less than 12 months 42% had stopped using Benzodiazepines GPs found the practices always useful

16. Problems ADS and Oldham PCT were reactive. Full treatment which brings success needs the support of a volunteer peer support group This needs a leader. We are lucky to have Barry This leader needs passion and determination in order to highlight need in communities It takes time to find these community volunteers ADS aims to bring forward a network to support the development of these specialist volunteers Lack of funding means need has to be evidenced

17. Success PCTADS Oldham Tranx