In 1996 The Eastern Health Board set up a Mobile Outreach Clinic for drug addicts in Dublin, Ireland. The goal of this services was to reach people in significant catchment areas are who were unable to secure places at treatment centers. The Mobile Outreach Clinic dispensed methadone and provided needle exchange, education, and support. The community outreach team was pharmacist and nurse led and by 2004 the mobile clinic had seven different locations it would go to daily, servicing 30 or more people at each location. To strengthen the services, we restructured and managed the mobile outreach clinic by developing patient safety initiatives, referral pathways to other long term stabilization clinics. Established a full-time methadone clinic for clients awaiting long-term programs. Communicated and liaised with government agencies to develop a screening, assessment and follow ups for Hepatitis C and HIV positive clients.
We Implemented a referral process to provide immediate detoxification or stabilization treatment for pregnant women as we seen it as essential to ensure that when pregnant substance users come into contact with our services, they could have access specialized, integrated care that would take all of their needs into account.
In Dublin, access to treatment was prioritized for pregnant opioid dependent women. The priority was designed to engage the woman, to have her access both prenatal and drug treatment services quickly, stabilize on oral methadone therapy, and address other health and social care issues as necessary. Stabilization of drug use was stressed, and women were encouraged to remain on oral methadone throughout their pregnancy. Dose reduction or escalation was determined by the prescribing doctor in collaboration with the woman. Methadone doses were individualized to take account of individual differences in tolerance and other medical issues (e.g., other medications, HIV, or HCV status). Informed consent to treatment was always sought and the women were always aware of their current dose of methadone. We worked with The Drug Liaison Midwife Services to help lessen the stigma for drug-misusing women and improved the relationships between the women and the obstetric and drug services and referred over 100 woman in the first year.
The Mobile Outreach Clinic has now evolved tenfold to Primary Care Safetynet who now employs GPs, nurses and support workers to provide services to homeless people and vulnerable groups. Safetynet Primary Care continues to identify gaps in health services and facilitate the development of new services with the aim of ensuring equitable health care for all.
https://www.irishtimes.com/news/dublin-gets-first-mobile-drugs-unit-1.99622