Health and Welfare System
People who have problems with drug and alcohol use can access help, drug rehab and treatment either through the health and welfare system (via drug advice services or GP referral) or through the criminal justice system if they have committed an offence.
Most areas of the UK have ‘street agencies’ or projects (sometimes called community drug services or drug action teams) which offer a range of services including information and advice, counselling, detoxification and prescribing for opiate users, needle exchanges and sometimes support groups and other services such as acupuncture. They are usually only open during normal working hours. While they may give information and advice over the telephone, they only see people by appointment, and have there are waiting lists.
GPs and Accidents and Emergency (A&E) Units
The main primary health care sources for people are their GP and the local hospital A&E department. GPs and hospitals make more referrals to specialist drug services and drug addiction treatment than any other point of contact. As well as referring patients on, GPs provide general medical services, information and advice and treatment (especially substitute prescribing) often in partnership with a drug agency or DDU.
DDU (Drug Dependency Unit)
These are usually located in, or adjacent to, a hospital, and specialise in helping problem drug users, especially people who are dependent on drugs like heroin. They provide counselling, detoxification, substitute prescribing and other treatments. An appointment is usually needed and waiting lists can be long.
Needle Exchange Schemes
These were set up in the 1980s in response to the spread of HIV among drug injectors. As well as giving out clean injecting equipment and collecting in used ‘works’, these services can offer information and advice, health check-ups, safer sex advice and condoms, and referral to other drug services. Some schemes are based in drug projects or hospitals but others operate from chemist shops. Some also use outreach workers who ‘injectors’ meet on the streets or in their own homes.
Outreach attempts to bring the service to the user. Detached work involves workers going into the user’s own environment. Examples include support and needle exchange workers going into user’s homes and support workers operating at raves and in clubs. Institutional work is where a service operates on the site of other agencies such as in a health centre, college or school.
Residential Services / UK Rehab Clinics
Residential drug addiction treatment programmes (drug rehab) are for heavily dependent drug users who are trying to give up drug use. Programmes usually last 3-6 months but some 12 steps programmes last for a year. These services are often based in rural settings. The types of programmes vary but tend to fall in one of four main types:
These operate a hierarchical structure which residents work through based on intense therapy sessions.
Drug Rehab: Minnesota model
This is associated with the Alcoholics / Narcotics Anonymous 12 step programme. It sees addiction as a disease, aims for long term abstinence and includes spiritual as well as practical guidance as part of the drug addiction treatment.
General House Programmes
These differ in their approach and are based on group and individual therapy.
Christian House Programmes
These are usually run by Christian staff with or without any required Christian structure. Where there is a specific religious requirement non-Christians will not be accepted.
NHS Choices provides a wealth of online information about addiction.
Drug Watch provides up-to-date information about prescription and over-the-counter medications including detailsof associated side effects.
Ask Frank offers free, confidential information and advice 24/7.
Drinkline has advisers available from 9.30am – 11pm during weekdays.
Self Help Groups
Alcoholics Anonymous co-ordinates local support groups for people with a desire to stop drinking.
Narcotics Anonymous co-ordinates local support groups for people who wish to stop their drug use.
Families Anonymous is for relatives and friends concerned about the use of drugs or related behavioural problems.
Criminal Justice System
Many problem drug users are referred for drug addiction treatment through the criminal justice system. Police Arrest referral schemes began in 1996 and have spread since. They range from people being given telephone numbers for helping agencies when they are arrested for a drug, or possibly drug-related, offence to drug workers operating in police stations.
A lot of people enter prison with a drug problem, and a lot of drug use takes place within prisons. A range of services have been developed within prisons including in-house treatment, information and advice. Currently, provision of clean needles is not allowed, although some prisons do provide sterilisation facilities. Prison doctors can refer prisoners on to helping services, provided either in-house or by workers from drug projects coming into the prison. Take-up of treatment is usually voluntary but the introduction of drug addiction treatment orders and drug testing means that prisoners can now be required to undergo treatment either in prison or while on probation.
Probation work aims to prevent re-offending, and part of this work is to minimise drug problems. Probation services usually have good contacts with health and drug agencies, and can refer individuals for drug addiction treatment. They also play an important role in supervising care and reporting to courts prior to and after sentencing.
Advice and Counselling
This can range from individual or group counselling as well as advice about safer use, housing, work, benefits, etc.
The aim of detox in drug addiction treatment is to reduce the amount of drug from the body prior to support to be abstinent. Doses of the drug are reduced until the user is drug-free. Usually this is done over a period of a few weeks but sometimes involves abruptly stopping. Detox programmes are available in hospitals but more commonly on a community basis where users remain at home and receive support to deal with withdrawal symptoms and become drug-free.
Methadone reduction programmes:
These involve prescribing methadone to heroin users to control withdrawal symptoms. The aim is to gradually reduce the quantity prescribed until the user experiences no withdrawal symptoms and is drug-free. The degree of reduction and length of time used to achieve abstinence can vary from a few weeks to several months. Motivation is a key to the success of such programmes. Participants regularly review their progress as part of their drug addiction treatment and usually receive therapy and support as part of the programme. Methadone reduction programmes usually take place in community settings.
Methadone Maintenance programmes:
Here, the aim is not to eliminate drug use in the short term, but to stabilise the use by prescribing methadone as a substitute for heroin. The idea is to reduce the need for criminal activity and the harm caused by injecting and to stabilise the user with a view to them giving up drug use in the longer term. Programmes are usually delivered in community settings.
Addiction Services for Younger People
Most drug drug rehab / alcohol rehab services are only equipped to deal with adult users – those over 18 years old. Confusion over legal issues about confidentiality and informing parents has resulted in some agencies refusing to see the younger age range. However, new initiatives have seen development of projects which specifically cater for younger age groups and the appointment of staff at existing agencies to work with young people.
This information is provided to assist in the finding of drug rehab centres, drug addiction treatment, drug and alcohol addiction orgainsation and services. The purpse is to add inditualy in seeking drug treatment and substance abuse device