2. Outcome of todays session
• Increased awareness of alcohol misuse issues
• Understanding of assessment and treatment
services
• Better understanding of how to deal with
alcohol problems
3. Health visitors regularly support people who are
negatively affected by their own or someone
else’s alcohol or other drug use.
4. Health visitors prioritise the well being of the
people they support –
working in a manner that is empowering,
compassionate and respectful
and to allow people
self determination and risk taking where no one
else is harmed.
5. Some DON’Ts…
• Don’t assume that other professionals will have assessed for
alcohol and drug problems
• Don’t be afraid to ask; you are already dealing with sensitive
personal issues
• Don’t worry if you don’t understand what people say about
drugs and alcohol; they can explain
• Don’t be judgemental; nobody starts drinking or using drug
intending to develop a problem
6. And some Do’s…
• Do expect there to be prejudice and stigma associated with alcohol and
drug users
• Do explain your role, what you can do and what you can’t do; talk about
confidentiality
• Do remember that even brief interventions can help people to change
• Do routinely address alcohol and drug issues – the more you practice the
better you will get
• Do find out about referral pathways to specialist services
• Do your best to view alcohol and drug use in its wider context: is it making
any problems worse or is t helping to reduce them ?
16. What targets to aim for…
Men and Women –
• 3 or less units daily
• 14 or less units weekly
• No drinking whilst pregnant
Brief interventions can and do make a difference.
17. Simple Structured Advice –
The Benefits of cutting down.
• Reduced risk of … Injury, of high blood pressure, of
cancer, of liver disease, of brain damage
• Sleep better
• More energy
• Lose weight – better physical shape
• No Hangovers
• Improved memory
18. Simple Structured Advice – The Benefits of cutting
down - Psychological/Social/Financial.
• Improved mood
• Less hassle for the family
• Reduced risk of drink driving
• Save money
• Better relationships
• Reduced risk of ‘disinhibited’ behaviour
19. Talking to people…ask the questions…
• Have you felt that you should cut down your drinking ?
• Do you ever drive when you have been drinking ?
• Is someone in you family concerned about your drinking ?
• Have you had any blackouts after drinking ?
• Have you ever been absent from work or lost a job because of
drinking ?
• Do you have to drink more than before to achieve
intoxication or the desired effect?
20. Risk assessment an unmet need…
• Suicide and self harm – prevalence greater
• Domestic violence and abuse – highly correlated with
problem drinking
• Mental ill health – often co-exists with substance misuse
• Physical Health – problems caused or exacerbated
• Child Care – may impair parental capacity
• Older people – often experience problems
21. FRAMES model – based on motivational interviewing.
Feedback on their alcohol use must be accurate and positive
Responsibility – be clear that the choice to change is and
responsibility for it rests with the client
Advice giving – give clear information and advice
Menu – offer a choice of change options
Empathy – adopt and empathic counselling style
Self Efficacy – promote independence
22. Supporting women who use alcohol…
• Problematic use often associated with domestic or sexual
abuse, including being abused as a child.
• 50% to 90% women may drink to escape such miseries.
(Womens Aid 2015)
• Self harm may be an issue
• Co-dependency
• Responding appropriately will be an enormous step forward.
I will be sharing some articles adult children of alcoholics, co-
dependency and Family and Drug Courts at end of the
session.
30. SAD - Q
Severity of Alcohol Dependence Questionnaire
The SADQ questions cover the following
aspects of dependency syndrome:
• physical withdrawal symptoms
• affective withdrawal symptoms
• relief drinking
• frequency of alcohol consumption
• speed of onset of withdrawal symptoms.
33. STRUCTURED TREATMENT and RECOVERY SERVICE
• Advice, support and information.
• Structured therapeutic interventions PSI : Psycho dynamic,
CBT, MI, EMI, BI, Humanistic,
• Key working - STARS Node Link Assessment Maps
• Group work – weekly groups or Structured Recovery
Programme – SRP
34. • Medical assessment – health MOT – BBV
• OST- Opiate Substitute Therapy
• Community and in patient detox – rehab
• Internal and external referrals – Oasis Republic, Employment,
Training Education, Housing, Social,
40. •
Some local STARS statistics: (end Dec 15)
341 alcohol only
709 people on OST
60 recorded as non-Opiate
136 Alcohol and non –opiate
Total clients in treatment = 1246
Average case load - 47
41. PHE Target – Reduce alcohol related hospital
admissions
•AA and SMART Recovery – mutual aid
•Local strategies – Drinks checker, Dry January
•Staff
•Referrals
•Actions
•Venues
•The future….
Im making two assumptions here
You are in the front line of health and social care services, alcohol can play a significant role in the lives of people who use services.
Should be able to intervene confidently and effectively
Cosr skills are ideally suited to work with people with alcohol problems
Don’t be afraid to ask questions,
Brief inteventions
This video covers some of the issues about alcohol, a USA version but covers what I wanted
Motivation to change
Never advice anyone to stop drinking
sudden withdrawel can cause serious health problems help people to think about change and support them to get the physical and psycho socilal treatment they need,
Motivation to change
Never advice anyone to stop drinking
sudden withdrawel can cause serious health problems help people to think about change and support them to get the physical and psycho socilal treatment they need,
Why working in units is good – it helps people identify what they are drinking and the amount that is safe,
Always have 2 or 3 days per week alcohol free
Ask questions ; what are people using, how much are they using, how often do they use, how do they use, what ae the effects on them, positive and negative, what happens if they stop using???
Slang is often used – ask them….
Say things like – your score suggest that you might be at risk of problems in the future….
You seem to be drinking at a rate that increases your risk of harm…
Benefits
Physical- reduced risk of - injury, high blood pressure, cancer, liver disease, Hepatitis, brain damage. Sleep better, more energy, lose weight, better physical shape, no hangovers, improved ,memory,
Improved mood, less hassle from family, reduced risk of drink driving, better relationships, reduced risk of sexual activity risk taking behaviour – drug use.
Empathic approach is effective – what about illegal drugs and the law,
Why working in units is good – it helps people identify what they are drinking and the amount that is safe,
Always have 2 or 3 days per week alcohol free
Ask questions ; what are people using, how much are they using, how often do they use, how do they use, what ae the effects on them, positive and negative, what happens if they stop using???
Slang is often used – ask them….
Say things like – your score suggest that you might be at risk of problems in the future….
You seem to be drinking at a rate that increases your risk of harm…
Why working in units is good – it helps people identify what they are drinking and the amount that is safe,
Always have 2 or 3 days per week alcohol free
Ask questions ; what are people using, how much are they using, how often do they use, how do they use, what ae the effects on them, positive and negative, what happens if they stop using???
Slang is often used – ask them….
Say things like – your score suggest that you might be at risk of problems in the future….
You seem to be drinking at a rate that increases your risk of harm…
Drinking is so common it is sometimes overlooked when there are other obvious problems, because alsochol use is the norm it should always be addressed – alcohol could be worse than other drugs,
Alcohol and drug problems are so prevalent amongst vulnerable groups it is everyones job to identify issues, take initial assessments and make referrals to specialists, working together is key.
Don’t just talk about it once ask more times if necessary, keep it in the regular conversation , there is no majic checklist of sign and symptoms to spot, routinely asking sensitive questions is vital.
People with drug or alcohol problems are often vulbnerable to other risks make sure you ask about them…
Child care – neglect and abuse should not be assumed ASSESS is support needed ?
People with drug or alcohol problems are often vulbnerable to other risks make sure you ask about them…
Child care – neglect and abuse should not be assumed ASSESS is support needed ?
More women only support services needed,
The Oasis Partnership is a local charity that has worked within Buckinghamshire for 29 years
We are a well-established part of the local drug & alcohol treatment system, supporting drug, alcohol users & their families and carers, as well as supporting a range of stakeholders to work effectively with our clients
Inclusion is a semi- autonomous part of SSSNHSFT & we currently employ approximately 400 staff
We are an experienced provider of drug, alcohol & psychological services in criminal justice, residential & community settings across the country. This includes the 3 Buckinghamshire prisons where, in the case of HMP Aylesbury we have had a presence since 2004
We are a values based organisation and are able to offer a unique combination of the safety & assurances of an NHS trust with flexibility & responsiveness. Our clinical governance structures are robust & accountable & will deliver a clinically safe service to the service users of Buckinghamshire.
Our Vision
An equal partnership of integrated and united staff
Integrated approach to service delivery – clinical, health promotion, pharmacological and psychosocial
An outward and inclusive approach – working in partnership
Bespoke Recovery Group Work Programme
Oasis Republic Recovery Network
The STARS service will be delivered from the 3 main hubs in identified areas of high need across Buckinghamshire, Oasis House in Wycombe, Unity House and 100a in Aylesbury and our new service Lewins Yard in Chesham, as well as from GP surgeries & other satellites and community venues across the county.
Dry January
Staff attend aa session as part of induction
Staff support access to aa verbally, taking people to a group, introducing to an aa members
Integrate aa into delivery of services – group work and SRP sessions, participants often support newbies into aa sessions
91 AA groups provided form within Oasis premises in q1 this year.
Dry January
Staff attend aa session as part of induction
Staff support access to aa verbally, taking people to a group, introducing to an aa members
Integrate aa into delivery of services – group work and SRP sessions, participants often support newbies into aa sessions
91 AA groups provided form within Oasis premises in q1 this year.
Dry January
Staff attend aa session as part of induction
Staff support access to aa verbally, taking people to a group, introducing to an aa members
Integrate aa into delivery of services – group work and SRP sessions, participants often support newbies into aa sessions
91 AA groups provided form within Oasis premises in q1 this year.
