Meeting People Where They Are: Reflections from the RCGP Addiction Conference

Sophie Given

Sophie Given is a registered nurse by background and is currently completing a PhD in Telemedicine at the University of St Andrews. Her doctoral research focused on how digital health can improve access to care for hard-to-reach population groups, including people experiencing substance use disorders. She presented her work on telehealth mediated medication assisted treatment at the Royal College of General Practitioners Addiction Conference. Alongside her academic work, she holds senior leadership roles within nursing education and serves in the Royal Naval Reserve Medical Branch.

The author declares no competing financial interests related to this blog. The telehealth mediated medication assisted treatment project was conducted as part of academic work at the University of St Andrews. No commercial funding was received.

I recently attended the Royal College of General Practitioners Addiction Conference in Liverpool, where I presented a poster on telehealth mediated medication assisted treatment and online engagement. The Pilot Study examined the Implementation of Telemedicine for Medication-Assisted Opioid Use Disorder (TMOUD) in NHS Fife and looked at how digital access can support people with opioid dependence who are not engaging with traditional services.

The conference was thought provoking, but the session that stayed with me most was on Scotland’s first safer drug consumption facility, The Thistle, in Glasgow and presented by Dr Saket Priyadarshi.

On the surface, telehealth and a safer consumption facility might seem very different approaches. One happens online, often in someone’s home. The other is a physical space designed for supervised use in a clinical space. What struck me is that both are trying to answer the same question. How do we reach people who are not being reached?

In our telehealth work, we have seen that some people are more willing to start a conversation online than in a clinic room. For individuals who have experienced stigma or who struggle with the structure of traditional appointments, the option of remote contact can make a difference. It does not solve everything, but it can lower the barrier to first contact.

The Thistle reflects a similar mindset. It recognises that people are already injecting drugs, often in unsafe environments. Rather than ignoring that reality, it provides supervised care with the aim of reducing overdose deaths and other harms. Listening to the team speak, what came through clearly was a focus on dignity and relationship building. The goal is not only to prevent immediate harm but to create opportunities for wider support when someone is ready.

Scotland continues to experience high levels of drug related drug-related harm. There is no single intervention that will change that on its own. Medication assisted treatment saves lives. Harm reduction services reduce risk. Digital pathways may widen access. These approaches should not compete with each other. They should sit alongside each other.

Presenting my poster reminded me that innovation in addiction medicine is not only about new treatments. Often it is about rethinking how people enter care. If we are serious about reducing harm, we need services that are flexible and realistic about the lives people are living. For me, the key message from the conference was simple: we must keep asking who is not in the room and why. Then we need to be willing to adapt our services so that more people can walk through the door, whether that door is physical or digital.