May 2015 |
drinkanddrugsnews
| 11
ExchangE
More good practice stories at
Often
those of us working in the alcohol
field have heard families and non-specialist
workers express the heartfelt view that,
‘There was nothing we could do because
they didn’t want to change their drinking.’
People believe that if a problem drinker
does not want to change, nothing can be
done. This is not true, but this negative
attitude has hampered the response to many
of the riskiest and most vulnerable drinkers.
According to Public Health England, 94
per cent of dependent drinkers are not
engaged with treatment at any one time. A
small group of these, so called ‘blue light’
clients, are both treatment resistant and
placing a huge burden on public services.
Since 2014, we have been working on the
Blue Light Project – our national initiative to
develop alternative approaches and care
pathways for this group. It has challenged
the traditional approach by showing that
there are positive strategies.
The project has developed the
Blue light
project manual
, which contains tools for
understanding why clients may not engage,
risk assessment tools that are appropriate
for drinkers and harm reduction techniques
that workers can use.
The manual also offers advice on crucial
nutritional approaches, which can reduce
alcohol-related harm, questions to help non-
clinicians identify potential serious health
problems and deliver enhanced personalised
education, and guidance on legal frameworks.
‘The response to the project has been
fantastic,’ said Mark Holmes, team leader of
the Nottinghamshire alcohol related long
term condition team, who worked with me
on the project.
‘It is filling a real gap in the health, social
care and criminal justice system. For too
long we have done nothing about this
challenging issue.’
Mike Ward is senior consultant at Alcohol
Concern
A free PDF version of the manual is
available at
Pathway to chaNge
Mike Ward
talks about a new project that is aiming to engage
dependent drinkers with treatment services
‘People
believe that
if a problem
drinker does
not want to
change,
nothing can
be done.’
It is widely acknowledged
that
professionals require support to improve
their knowledge and confidence in the
assessment and management of the acute
and chronic harms resulting from the use of
club drugs and novel psychoactive
substances (NPS).
With support from the Health
Foundation, project NEPTUNE has responded
to the gap in knowledge by developing
guidance based on the best available
evidence and clinical consensus.
The challenges include those resulting
from the drugs themselves: what are they
and how do they work? There is a rapidly
changing profile and ever-increasing numbers
of substances available, and the potential
harms of the NPS are still poorly understood.
NPS appear to be attracting a new group
of younger users, and engaging them is a
particular challenge for drug services.
Clinicians require improved knowledge of
who is using club
drugs, and how.
Services generally
have limited
understanding of the
diverse ‘cultural’
contexts of club drug
use (for example,
festivals, sexual
context, psychonautic
use), or the context of
use, risk and harm.
There are new challenges associated with
the clinical management of club drugs and a
need to improve ‘clinical’ knowledge of how to
manage acute/chronic presentations. The
overlap of substance misuse harms with other
harms has also compelled drug treatment
professionals to develop knowledge and
clinical pathways in uncharted territories.
NEPTUNE guidance is also aimed at
emergency departments, primary care and
Dima Abdulrahim
talks about
meeting the treatment challenges of
novel psychoactive substances
‘The
potential
harms of
NPS are still
poorly
understood.’
Novel ideas
sexual health clinics. Not only do these
services manage the harmful effects of
club drugs, but they also provide a good
access to populations with high levels of
use. This makes for a strong opportunistic
approach to access people who may be in
need of drug treatment, but reluctant or
unwilling to contact services.
Dima Abdulrahim is NEPTUNE
programme manager and lead researcher
