Case Study: Mobile Outreach Methadone Clinic

 

Introduction:

In 1996, the Eastern Health Board established the Mobile Outreach Clinic in Dublin, Ireland, targeting drug addicts. The primary goal was to extend healthcare services to individuals in challenging catchment areas who struggled to get treatment. Providing methadone, needle exchange, education, and support, this clinic embarked on a transformative journey. Claire McDevitt, the founder and principal of Healthcare Solutions, initiated and established this clinic. 

 

Challenge:

Limited treatment centre availability and societal barriers to drug users required a dynamic solution. The mobile clinic aimed to provide essential services while removing barriers that hindered pregnant women’s access to specialised care.

 

Approach:

The approach was holistic and community-focused. The full-time methadone mobile clinic, led by pharmacists and nurses, offered methadone and needle exchange for clients awaiting long-term programs. Collaborating with government agencies, Claire introduced screening, assessment, and follow-ups for Hepatitis C and HIV positive clients.

Treatment was prioritised for pregnant opioid-dependent women where they could access prenatal and drug treatment services quickly, stabilise on oral methadone therapy, and address other health and social care issues as needed. It was essential for pregnant substance users to access specialised, integrated care for all of their needs.

Stabilisation of drug use was encouraged and women were encouraged to remain on oral methadone throughout their pregnancy. Dose reduction or escalation was determined by the prescribing doctor and patient. Methadone doses were personalised and took into account other medical issues (e.g., medications, HIV, or HCV status). Informed consent to treatment was always sought.

Claire worked with The Drug Liaison Midwife Services to reduce the social and professional stigma and improved the relationships between the women and the obstetric and drug services.

 

Outcomes:

The Mobile Outreach Clinic has now evolved into Primary Care Safetynet, a comprehensive service provider for homeless individuals and vulnerable groups. With a team of GPs, nurses, and support workers, they continue to address healthcare gaps, ensuring equitable access to care for all.

The Clinic referred over 100 pregnant women in the first year.

 

Conclusion:

The journey of the Mobile Outreach Clinic epitomises healthcare transformation driven by compassion and innovation. Reaching marginalised communities in a way that has now evolved into a comprehensive care provider, the clinic has built a legacy of accessibility, equity, and collaboration. Claire is proud to have been at the helm of this program, which demonstrates her personal values in healthcare reform. More information about the initiative can be found in these links: 

www.irishtimes.com/news/dublin-gets-first-mobile-drugs-unit

www.primarycaresafetynet.ie/aboutus