Key to Services

Click on the links below to view the service descriptions

               ·   Aftercare Activities

               ·   Community Prescribing

               ·   Counselling

               ·   Hepatitis B Vaccinations

               ·   Information & Support

               ·   Needle Exchange

               ·   Outreach Programmes
 

               ·   Assessment & Care Planning

               ·   Complementary Therapy

               ·   Drug Intervention Programmes

               ·   Housing Support

               ·   In-patient Detox

               ·   One to One Work

               ·   Structured Group Work
 

Aftercare is a package of support that is put in place for clients when  they leave
structured treatment (after the end of their care plan), or for offenders when they
leave or complete community sentences, or are released from prison (remand or
sentenced). The aim of aftercare is to sustain treatment gains and further develop
community reintegration. Aftercare may include drug-related interventions, open
access relapse prevention or harm reduction. It may also include non-drug related
support such as housing, access to education, generic health and social care.
 

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A two-way process between a service user and an assessor to establish
immediate and longer terms needs, and develop a care plan of actions to meet
those needs. Comprehensive assessment aims to determine the exact nature of
the client’s drug and alcohol problems, and co-existing problems in the other
domains of health (mental and physical), social functioning and offending.
Assessment may be conducted by more than one member of a multidisciplinary
team, because different competencies may be necessary to assess different
areas of client need. Assessment should be an ongoing process rather than a single event.
 

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Community Prescribing

This involves the provision of care-planned specialised drug treatment, which
includes the prescribing of drugs to treat drug misuse. The range of community
prescribing interventions can include:
•  Stabilisation on substitute opioids, including dose titration
•  Prescribing for a sustained period to substitute illicit drugs
   (maintenance prescribing)
•  Prescribing for withdrawal from opioids (community detoxification)
•  Prescribing to prevent relapse
•  Stabilisation and withdrawal from sedatives
•  Detoxification from alcohol where appropriate
•  Treatment for stimulant users, which may include symptomatic prescribing

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Offered in both community-based and residential drug services providing a range
of complementary therapies including: auricular acupuncture, homeopathic medicines and teas, visualisation, shiatsu and reflexology. Therapies are reported to help with the withdrawal and relieve stress. Staff providing these therapies should hold appropriate qualifications.

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Counselling is defined by the British Association of Counselling as “providing an
opportunity for the service user to work towards living in a way he or she
experiences as more satisfying and resourceful”. This activity takes place within
a deliberately undertaken contract with clearly agreed boundaries and
commitment to privacy and confidentiality. It requires explicit and informed agreement. Staff should be adequately trained and hold qualifications to provide counselling. It is important that people requesting counselling should find out about the philosophy/approach being offered as counselling can vary depending on a person's training. Counselling services usually offer service users a choice of counsellor. The assessment interview is a good time for service users to check out what counselling involves prior to starting.

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Drug Intervention Programmes provide an end-to-end service (enhanced Tier 2) for
drug users who are within the criminal justice system. The DIP teams provide a
range of support services through the various stages of the justice system and
beyond:

•  police custody
•  courts and probation
•  prison
•  referral to treatment
•  throughcare and aftercare

Special measures for children and young people are also being implemented.

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Preventing the spread of blood-borne diseases is a major goal of drug treatment
services and a major contribution to individual and public health. A range of
services which may be offered, including some or all of the following:

•  health screening for blood-borne infections in order to identify health needs
   and problems
•  explore issues relating to their health as a result of substance use/misuse
   and identify ways of achieving a healthier lifestyle
•  assess risk behaviours associated with drug and alcohol use and provide
   interventions that will help prevent further harms and consequences,
   eg. advice and education on the transmission of hepatitis B & C and HIV
•  provide access to testing for hepatitis B & C and HIV
•  provide access to hepatitis B vaccination
•  provide a comprehensive pathway of care for those who require healthcare
   relating to blood-borne diseases

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Whereas, many services will provide basic information and referral for housing
issues, full housing support is a specialised service to provide or identify suitable
living accommodation for people with a history of drug or alcohol misuse. Housing
may be provided within a hostel, through supported accommodation or within a
residential treatment setting.

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Drug and alcohol (substance misuse) related advice and information interventions
should provide appropriate advice and accurate, up-to-date information on a range
of substance misuse related issues, including:

•  information about different drugs and their effects
•  advice about stopping misuse of drugs and alcohol
•  information on how to reduce the potential harm from drug misuse
   (eg. safer injecting, reducing overdose risks, etc)
•  how and where to access help for drug problems
•  how and where to access help for other problems
   (eg. housing, sexual health etc)

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Inpatient interventions usually involve short episodes of hospital based (or
equivalent) drug and alcohol medical treatment. This normally includes 24-hour
medical cover and multidisciplinary team support for treatment such as:

•  Medically supervised assessment
•  Stabilisation on substitute medication
•  Detoxification from illegal and substitute drugs
•  Specialist inpatient treatments for stimulant users
•  Emergency medical care for drug users in crisis

Inpatient drug treatment should be provided within a care plan with an identified
keyworker. The care plan should address drug and alcohol misuse, health needs,
offending behaviour and social functioning where appropriate.

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Needle exchange facilities are located in open access (Tier 2 services), or community pharmacies (Tier 1). Sometimes needle and syringe exchange
services are also provided in mobile vans, especially in rural places. Needle and syringe exchange schemes offer a range of injecting equipment as well as a service for the disposal of used equipment. In addition, staff offer harm minimisation or risk reduction advice and information. Some needle exchange service also offer on-site vaccination programmes for Hepatitis B. The service can also act as a point of referral into other services.

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One to one work can have a different interpretation between services, so it is
important that service users clarify what is being offered. Generally one-to-one is
not counselling. It usually involves a member of staff being allocated as a key
worker. Their role is to meet with the service user regularly, check progress
against the care plan, provide advice and information; and give general support e.g. letters to housing etc. In some services staff may also be expected to do all
the therapeutic work, this could include; motivational work, lapse/relapse prevention, coping skills and behaviour change work. Some services may also work within a philosophy, eg. harm reduction or abstinence, this is important to check when engaging with a service.

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Outreach work is a method of delivering interventions in settings external to a
service's usual site. The aims of outreach work are:
 
•  to provide services to those unable or unwilling to access site-based
   services, including ‘hard to reach’ groups such as young people, black and
   minority ethnic communities, women, the housebound (eg. because of
   physical or psychological illness) and those living at distance from services
   (eg. in rural areas)
•  to provide health education opportunities for drug misusers not currently
   accessing site-based services
•  to provide harm minimisation/risk reduction services to drug misusers not
   currently accessing site-based services (eg. needle exchange, provision of
   condoms)
•  to make initial contact with drug misusers to facilitate referral to site-based
   services

Services can include the provision of advice and information, brief interventions,
sterile injecting equipment and, in some instances, care-planned counselling.

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Usually offered as part of a programme of defined activities for a fixed period of
time. Service users usually attend the programme according to specified
attendance criteria, and follow a set timetable that will include group work, covering
psychosocial interventions, educational and life skills activities. Some service
users may attend as a follow-on or precursor to other treatment types, or may be
attending as part of a criminal justice programme supervised by the probation
service, or community rehabilitation. Group work is normally run in community
based services, set in centres that have been specifically designated for the
programme (purpose-built or converted) and have rooms designated for specific
parts of the programme (eg. group work, life skills etc).

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This website has been produced on behalf of the Hampshire Drug & Alcohol Action Team by WMC Limited.
If you have any comments or to advise of any updates please email update@hantsdaatdirectory.org.uk.