Terms & Conditions

Terms

Any transaction concluded between you and Stability Of Dose Assessor (SODA) tool located at www.mydose.digital 'the website' is subject to your acceptance of The Drug School (TDS) Limited's terms and conditions as stated below:

1. TDS reserves the right to change these terms and conditions at any time. Any change will take immediate effect as soon as it is posted on the Website.
2. All contracts concluded between you and TDS will be governed by the law of England. In the event of a dispute, the matter shall be resolved in the courts of England.
3. Any communication to TDS, including any notification, query or complaint, should be addressed to TDS at:

GDS
Email: adam@thedrugschool.com

The Drug School's Privacy Policy

1. The Drug School Limited (TDS) values the right to privacy and this Privacy Policy (“the Policy”) demonstrates TDS's firm commitment to the promotion and protection of this fundamental right.
   1. This Policy seeks to explain TDS's personal information collection and dissemination practices, and the measures implemented for the protection of your privacy.
   2. In the event of reform or amendment to the law, TDS may change the Policy. Any amendment to the Policy will be posted on this website www.thedrugschool.com or at www.mydose.digital (“the Website “).
   3. TDS will not keep any personally identifiable information on you. Your data is anonymous and confidential. If you are asked to submit an email at the start of the SOSA tool it so that you can email yourself a copy of your password. In the event you lose this we will not be able to retrieve your information.
   4. TDS may ask you submit an e mail at the end of the SODA tool and request that you can be contacted for follow up in the future to assess the value of the SODA tool to you or to share important harm reduction information updates. This email is not linked to your data. Your decision to do is entirely up to you.
2. The Website is hosted and maintained by a third party on TDS's behalf on a remote server.
   1. The Third Parties' right to access information is strictly governed by a written contract between TDS and the Third Parties.
   2. The Third Parties are not authorised to access or process information for any purpose other than to discharge their contractual obligations to TDS
   3. The Third Parties are not authorised to use information for their personal marketing purposes.
3. TDS will use your pool anonymised data to improve the functionality of the SODA tool an assist its evaluation. Your consent will be required prior to starting the SODA to ensure this consent is explicit. Because your data is anonymous and confidential its collection and its use is compliant with GDPR.
4. TDS aims to maintain all information collected and processed as accurately as possible. If you would like to review or amend the details you have provided, please note this is only possible you should need to provide your e mail, unique ID and password (only you have access to these), please contact TDS.
5. TDS is registered with the data protection agency in the UK. In compliance with the Data Protection Act 1998, for the protection of privacy, TDS implements strict security procedures for the storage and disclosure of information transmitted to GDS. These procedures are intended to protect information from unauthorised access, modification, loss and destruction. TDS uses industry standard practices to safeguard confidentiality. However, TDS cannot guarantee secure transmission of information over the Internet.
6. TDS will not be held liable for the contents, privacy statements and practices of other websites that are, accessible from the Websites. TDS recommends that you read the privacy statements of each site accessed. Links made available on the Websites should not be taken as an endorsement of the contents and views contained in those websites.
7. Under the Data Protection Act 1998 you are entitled, upon written request and payment of a fee, to be given a description of all personal information held by GDS about you, the purposes for which this is being held or processed and the recipients to whom this may be disclosed, subject to Sections 7 and 8 of the Data Protection Act 1998. However, since your data is anonymous and confidential, this will only be possible should you provide your e mail, unique ID and password to TDS.
8. Like most web sites, we gather certain information automatically and store it in log files. This information includes IP (Internet Protocol) addresses, browser type, internet service provider (ISP), referring/exit pages, operating system, date/time stamp and clickstream data. We use this information to analyse trends, to administer our site, to track users' movements around our site and to gather demographic information about our user base as a whole. To protect against fraud, we may link this automatically-collected data to information submitted at www.mydose.digital.
9. Cookies are small text files stored on your computer by a website that assigns a numerical user ID and stores certain information about your online browsing. We use cookies on our survey site to help us provide you a better experience and to provide quality control and validation functions. No personal information is stored on any cookie that we use.
10. Despite TDS's best efforts to prevent unsolicited e-mail ('spam') being sent to you, spam may sometimes get through. TDS does not send spam and views spam as a serious violation of privacy and a misuse of the Internet. If you receive spam from an address bearing the domain name “mydose.digital”, please contact TDS. TDS will endeavour to trace the source and take reasonable steps to try and prevent further spam being sent to you from that source.
11. If at any time you have any questions or concerns about TDS's privacy commitment please contact TDS by e-mailing adam@thedrugschool.com writing to The Drug School Limited 14 Amherst Ave London W13 8NQ
12. Other individuals who have access to a computer that you have used may be able to discover what websites you have browsed by accessing its computer history file or cache file. Please take care to protect access to your on-line personal details.

Privacy Statement

Thank you for using the SODA tool at www.mydose.digital.

1. Your data is anonymous and confidential.
2. We promise to protect your privacy and treat the information you give us as confidential.
3. The information you provide will be used to allow you to track your progress over time as and when you decide you adjust your dose of OAT (methadone or buprenorphine) and / or simply alter your drug behaviours. In time we will allow people on different doses of medication to compare their stability scores on the SODA with the average scores from people on the same or other doses. We will do this to show how average stability scores tend to improve (i.e., move towards zero) as mean doses of medication increase.
4. We may use your data to support the preparation of academic publications and work with user advocacy groups to improve drug education for those receiving treatment for opioid dependence.
5. We may use your data to provide different health providers with a summary of how people under their care are doing in respect to their drug treatment.
6. We will never try to sell you anything and we will never sell your personal data to anyone. That is not our business. We are a harm reduction and health education service, our aim to help people be as healthy and happy as they can be.
7. Your decisions about participating in the SODA and responding to specific questions or discontinuing participation will be respected without question.
8. We only collect personal contact details if you wish to provide them.
9. Where you have provided your email address or mobile number expressing your interest in being contacted at a later date so we can better understand how the SODA may have been useful to you, this data is stored on a separate server and not linked to your drug use data.

About the SODA app

The SODA tool - created by Professor Adam R Winstock

The SODA tool was developed by Adam R Winstock who is a Consultant Psychiatrist and Addiction Medicine Specialist, trained in the UK and Australia. He has been prescribing methadone and buprenorphine for over 20 years. After initial creation the tool was extensively revised based on feedback of experts in harm reduction and advocacy groups including Matt Southwell, Roz Gittins and EUROINPUD.

The SODA Tool: The Stability of Opioid Dose Assessor - helping people to work out what the right (optimal) dose of methadone or buprenorphine OAT (Opioid Agonist Treatment) is for them. The optimal dose is one that leave people free from withdrawal between doses for at least 28 hours a day, reduces craving, on top use and does not cause sedation.

Background

For people with opioid dependence, being on the correct (optimal) dose of methadone and buprenorphine (OAT) is an important factor in treatment efficacy. NICE and the Orange guidelines recommend therapeutic doses of methadone in the range 60—100mg and buprenorphine 8-16mg. Higher doses of methadone are associated with less heroin use (Strain et al 1999) and better retention in treatment (Caplehorn et al 1991). However, people vary in their optimal dose should be titrated based on individual response and to full effect in each individual patient (Traffton et al 2006).

Underdosing leaves people at risk of use and overdose. Although there is no recent National UK data on mean doses of methadone and buprenorphine prescribed in the community, a study reporting on 6-year data from 2007-2015 (published 2015 - Marteau et al) indicated that the mean dose of methadone was 46mg and buprenorphine 10mg. In my own recent clinical experience, many services mean doses approaching 60mg. In the USA the issue of optimal dosing is also an issue with two thirds of over 400 patients in treatment for opioid dependence being on less than the minimum recommended dose of 60mg /day (Brady et al 2005).

According to the 2017 Orange Guidelines 'there is a consistent agreement among experts that greater benefit is achieved by maintaining individuals on a daily dose between 60 and 120mg of methadone, although some individuals will stop using heroin at lower doses'. A 1991 study by Caplehorn identified that maximum daily dose of methadone dispensed during the study period was a highly significant predictor of retention. The relative risk (RR) of leaving treatment was halved for subjects receiving 60-79 mg and halved again for those who received 80+ mg. Negative attitudes to methadone (among other factors including lower age, lower dose and cocaine use) also contribute to poorer retention in treatment (O'Connor et al 2020). While there a number of scales used to assess opioid withdrawal and can be used during induction onto buprenorphine or to assist withdrawal management (e.g., OWS, COWS, SOWS) there are none that focus on the issue of guiding patients as to what their own optimal dose is.

Many of those receiving OAT have poor understanding of how treatment works including issues relating to dose and benefit, which limits the efficacy of treatment (Winstock et al 2009 and Alves and Winstock 2011. Seven years ago Professor Winstock uploaded a 9-minute video about how to get your dose right on methadone and buprenorphine on YouTube which has been seen over 55,000 times and has received many positive comments highlighting the absence of understanding of issues related to dose. To help patients get the most of treatment they need to have a clear understanding of how treatment works, the possible benefits of higher dosing and most importantly what the right dose is for them instead of being obsessed by a magic number or focusing on the fact that higher doses will result in longer period of dose reduction to come off. Treatment providers also need to be respectful of people want different things from treatment at different times in their lives, including helping them control their illicit use as opposed to stopping it altogether. The SODA tool accepts these different views on treatment outcomes.

In order to help patients, get their dose right and based on over 20 years of prescribing OAT Professor Winstock developed the Stability of Opioid Dose Assessor (SODA). The SODA aims to help patients identify for themselves what the right (optimal) dose is for them. Put simply, the optimal dose of OAT is one that leave people free from withdrawal between doses (preferably for at least 28 hours so for those on supervised dosing, getting their dose does not become a preoccupation or cause of distress if other activities need to be attended to or they are unable to pick their dose up at their usual time) reduced craving, cessation or significant reduction in regular on top use and does not cause sedation.

Once approved and as numbers of users increase, the SODA will be able to provide individuals not only with advice on their current dose and how their stability changes with dose adjustments but also show them how their current stability compares to others on the same dose, and highlight the common peer experience that those on higher doses are generally more stable. A companion tool currently being developed will help guide people in their dose reduction to help them feel in control of their medication reduction program.

How to contact us

Questions regarding this policy, complaints about our practices and access requests should be directed in writing to the Director, The Drug School Limited 14 Amherst Ave London W13 8NQ or by email to adam@thedrugschool.com

We will investigate all complaints and attempt to resolve those that we find are justified. If necessary, we will amend our policies and procedures to ensure that other individuals do not experience the same problem.