Opiate dependence can make life chaotic and unmanageable. The Alcohol and Drug (A&D) Service in Jersey offers free treatment and support for Islanders struggling with opiate dependency.
Seeking treatment is a big step, and you might feel an urgent need to see someone right away. You don’t need a GP referral to access support and treatment; you can refer yourself.
Call or email the A&D Service to refer yourself for support and treatment.
When your referral is received, we will see you for an initial assessment as soon as possible, depending on your individual needs and our availability.
Initial assessment
Initial assessment includes 2 appointments, each lasting around 90 minutes. A qualified nurse, experienced in supporting people with drug dependency, will conduct these assessments. They will take the time to talk to you and find the right Medically Assisted Treatment (MAT) for you.
Medically Assisted Treatment is crucial in drug dependency treatment but must be combined with psychosocial interventions and other treatments. A keyworker will help you develop your recovery plan. This plan will consider the other areas of your life where you may need support to aid your recovery and develop a healthier, more sustainable lifestyle.
After your assessment, we will introduce you to your keyworker. You will see your keyworker regularly, especially at the beginning of your treatment, until you achieve a stable, balanced state. This is known as stabilisation.
The Harm Reduction Worker
While you wait for an initial assessment appointment, you will be offered support from our Harm Reduction worker. This support will continue until your first appointment date. We strongly encourage you to accept this support but understand that this is your choice.
When you see the Harm Reduction Worker, you will have opportunity to discuss the health risks associated with opiate and other drug use, particularly if you have been using them intravenously.
You'll receive:
- overdose prevention training
- advice on managing an overdose
- safer injecting information
- health education
- screening and access to treatment for blood-borne viruses
Your personal information is kept confidentially, and we will discuss this further at your appointment.
Find out more about the support offered by the Harm Reduction Worker at the Needle Exchange.
Withdrawal symptoms
Anyone who is dependent on opiates will experience physical withdrawal symptoms when they try to stop using.
These symptoms can include:
- agitation
- anxiety
- muscle aches
- runny nose
- sweating
- yawning
- insomnia
- goose bumps
- abdominal cramping
- diarrhoea
- dilated pupils
Withdrawal symptoms are most intense 12 to 24 hours after the last dose and can last between 36 and 72 hours. Symptoms usually subside significantly after 5 days. The experience can vary from person to person, and the fear of discomfort can be significant.
Medically Assisted Treatment (MAT)
Several MAT options are available to treat opioid dependency, each working in different ways to:
- help manage withdrawal symptoms
- reduce cravings
- prevent relapse
The MAT options available from the A&D Service in Jersey include:
Methadone
Methadone is a well-researched, gold standard treatment for opioid dependence. It is a full opioid agonist, meaning it activates the same opioid receptors in the brain as other opioids, but in a controlled and sustained manner over 24 hours.
Methadone reduces cravings and withdrawal symptoms without producing the same high. This provides stability and reduces harmful behaviours associated with opioid dependency.
Methadone comes in liquid form and is consumed daily at a local pharmacy until you are stabilised from substance use. It takes time to build up in your body, so your dosage will be gradually adjusted to find the right amount for you.
This process is guided by the severity of your opiate withdrawals and the effectiveness of the medication over 24 hours, ensuring you are comfortable, and withdrawals cease, preventing over-sedation or possible overdose.
Buprenorphine
Buprenorphine is a partial opioid agonist that activates opioid receptors to a lesser degree than full agonists like heroin or methadone. It reduces cravings and withdrawal symptoms while having a ceiling effect that lowers the risk of misuse, dependency, and side effects. An opioid blocker can be added to prevent misuse.
At the A&D Service, the primary oral Buprenorphine drug used is Espranor. Espranor is a freeze-dried wafer-like tablet that dissolves quickly on the tongue. The dosage and frequency depend on the individual's condition and response to treatment.
Espranor dissolves quickly compared to other forms of Buprenorphine that are dissolved under the tongue, which helps you stick to your treatment and reduces the chance of misuse. Buprenorphine, with its partial agonist properties and ceiling effect, lowers the risk of misuse and overdose compared to full opioid agonists.
Dose adjustments are made based on your needs and physical withdrawal symptoms, under professional supervision. The medication is taken daily at a local Community Pharmacy until stabilisation from illicit drug use is achieved, ensuring effectiveness and monitoring for side effects.
Buvidal
Buvidal is a long-acting injectable form of Buprenorphine. A qualified healthcare professional administers it weekly or monthly,
Buvidal provides a steady release of Buprenorphine over time, which helps maintain consistent levels of the drug in your body. This consistency can make it easier for you to stick to your treatment plan compared to taking oral medication every day.
It binds to opioid receptors in the brain, reducing withdrawal symptoms and cravings without producing the high associated with full opioid agonists like heroin or morphine.
Buvidal's long-acting nature enhances treatment adherence and convenience, reduces the risk of misuse, and maintains stable medication levels in the body.
Naltrexone
Naltrexone is a medication that helps you stay abstinent from opioids after you've completed a treatment program. It is an opioid antagonist that blocks opioid receptors, preventing euphoria or pain relief from opioids. It helps prevent relapse by eliminating the rewarding effects of opioid use.
Taking it daily in pill form can make it easier for you to stick to your recovery plan. The A&D Service may recommend Naltrexone, but you'll need to get a prescription from your General Practitioner (GP) to start taking it.
Medical supervision
All MAT options are used under the supervision of qualified healthcare professional to:
- ensure safe treatment
- monitor progress
- adjust dosages
- manage side effects
Medically Assisted Treatment can significantly improve recovery outcomes, helping you achieve and maintain recovery while reducing risks.
These medications are part of a comprehensive treatment program, including counselling and psychosocial support, to help you make sustainable lifestyle changes and aid in your recovery journey.
Stages of recovery
There are 7 recognised, key stages of change people go through to change addictive behaviours.
The stages are:
- Precontemplation: not yet considering change, often due to denial or lack of awareness
- Contemplation: acknowledging the problem and thinking about change but not ready to commit
- Preparation: planning for change and taking small steps toward it
- Action: actively modifying your behaviour and environment
- Maintenance: working to sustain changes and prevent relapse
- Relapse: Returning to old behaviours is common and seen as a learning opportunity
- Termination: sustained change, no longer feel tempted to revert
We can offer support and treatment at any of these stages. The type of treatment and support will differ depending on the stage you're at.
Factors affecting opiate dependency
There are many factors that can contribute to a dependency on opiates. These may be biological, psychological, or social. This highlights the need for a multifaceted approach to prevention and treatment, addressing both the underlying causes and the dependency itself.
The A&D Service provide personalised advice and support.
Biological factors
Opiates stimulate dopamine release, creating euphoria and pleasure, leading to physical dependence. Over time, tolerance and dependence can develop, leading to misuse.
Some individuals have a genetic predisposition to dependency.
Psychological factors
Opiates provide temporary relief from emotional trauma like:
These conditions can lead to self-medication with opiates. The immediate pleasure from opiates can reinforce their use, leading to dependence.
Social and economic factors
Exposure to drug use in your social circle can increase the likelihood of opiate use. Financial stress and limited access to healthcare can drive opiate use as a form of escape.
Initial medical use
Opiates are powerful painkillers, you may start using opiates following a legitimate prescription for pain relief. Long-term use can lead to dependence.
Neurological adaptations
Repeated use requires increasing doses to achieve the same effect. Fear of withdrawal symptoms perpetuates continued use.
Trauma
Trauma significantly affects mental, emotional, and physiological states, increasing susceptibility to addiction. Childhood trauma can have a particularly damaging effect.
Trauma can lead to self-medication, emotional dysregulation, and avoidance behaviours.
Social and environmental links
Adverse Childhood Experiences (ACEs) can increase the likelihood of substance use disorders.
Social isolation and living in environments with prevalent drug use can also increase addiction risk.
Behavioural conditioning
Traumatic experiences can lead to impulsive and risk-taking behaviours. Substances provide relief from trauma symptoms, which can lead to routine use.
Co-occurring disorders
Trauma and addiction often co-occur with other mental health disorders. Effective treatment means addressing both trauma and addiction simultaneously.
Intergenerational Trauma
Trauma can be passed down through generations, increasing susceptibility to addiction.
Effects of opiate dependency
Opiate dependency affects many aspects of life, leading to severe physical, psychological, social, and economic consequences:
Physical health
Tolerance and dependence develop quickly, leading to withdrawal symptoms and health issues like infections and respiratory problems.
Mental health
Addiction often co-occurs with disorders like depression and anxiety, impairing cognitive functions and causing mood swings.
Social life
Dependency strains relationships, leads to isolation, and may result in illegal activities to fund the habit.
Legal issues
Possession and use of opiates can lead to arrest, imprisonment, and legal battles over parental rights.
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