Professor John Strang

Professor Sir John Strang is one of only six addictions researchers outside North America identified by ISI (the Institute for Scientific Analysis) as a “Highly Cited Author” with a rate of citation in the “top one half of one percent of all publishing researchers in the last two decades”. He has published extensively in the addictions field, with more than 500 publications, and is Head of the Addictions Department. He also has extensive experience as a Lead Clinician for a wide range of treatments in community and residential settings and has been a Consultant Psychiatrist in addictions treatment for over 30 years.

Professor Strang is Head of the Addictions Department and is also Leader of the Addictions CAG (Clinical Academic Group) within King’s Health Partners, in which Addictions is one of the core areas of the Academic Health Science Centre (AHSC). This brings together university partners King’s College London (KCL) with the NHS from South London and Maudsley NHS Foundation Trust, King’s College Hospital, and Guy’s and St Thomas’s NHS Foundation Trust.

The Addictions Department itself is hugely productive. The highly influential report by RAND Europe rates Substance Abuse Research at the National Addiction Centre as leading the field in UK Universities, with our Addictions (Substance Abuse) publications leading the field at 13%, with all other institutions except two scoring under 5%.

Professor Strang has chaired and/or served on key committees or guidelines groups for the Department of Health, for NICE (the National Institute of Health and Clinical Excellence) and for the World Health Organisation (WHO). This provides opportunity to bring relevant evidence from new scientific studies and systematic reviews to the policy-making work of these committees.

Ultra-portable fast-dispersal buccal naloxone tablets for constant carriage: Can they be manufactured? Are they acceptable and valued by users and family members?

Background: Naloxone nasal spray has been an important development, opening pathways for the introduction of take-home naloxone (THN) to new countries (e.g. Sweden) and to the wider workforce (e.g. police). However, it has limitations. It assumes healthy nasal mucosa (consider colds, hayfever, drug-related scarring, overdose-induced vomitus). It is also moderately bulky, contributing to reported poor naloxone carriage rates.

With university pharmaceutical sciences partners, we have produced rapid-dispersal wafer formulations (Alqurshi et al, Molecular Therapeutics, 2016). But this is of little value whilst languishing on a university laboratory bench.

Funding approval has been secured to task manufacturers to test feasibility to produce rapid-dispersal tablets in a credit-card-sized format to achieve high carriage rates, to liaise with the Medicines and Healthcare products Regulatory Agency (MHRA), and to investigate end-user acceptability.

Method: A major element of work is tasking the manufacturing industry (Catalent) to establish if they can adapt ‘Zydis’ technology to produce stable rapid-dispersal tablets in the desired format at a range of naloxone doses. A second element is consultation with MHRA (through pharmaceutical company Adapt) to advise on the next-step healthy-volunteer study of safety, pharmacokinetics and optimal dose, including special attention to the speed of onset and duration of action. The third element involves focus group and individual consultations with individuals with relevant lived and living experience, family members and commissioners to establish the acceptability of different formats and implementation strategies.

Conclusions: We must always look for improvements to our current valued interventions. We need partnerships to contribute different skills. Buccal rapid-dispersal naloxone could transform portability and constant availability if results are positive.