Drugs and AlcoholSubstance use treatment as part of a ‘wrap-around’ package of care.In the ‘austere’ UK financial climate, it seems unclear whether treatment services will be forced to bunker down and focus on substance use objectives, or instead be supported to expand into holistic providers of, or gateways to, the range of psychosocial services demanded by government reintegration and recovery agendas. Given the typically multiple, severe, and overlapping problems presented by treatment caseloads, it seems obvious that a holistic approach would help get patients back on a stable (recovery) footing, and similarly obvious that just focusing on substance use objectives would be setting some patients up to fail. Could ‘wrap-around’ care be the answer, and should treatment services have the flexibility to determine the extent to which this would be implemented in practice, or would this risk a lottery of comprehensive care?Drugs and alcohol recoveryPatient care managementTreatment factorsHealth care deliveryDrug or health care worker2017-10-03Drug and Alcohol FindingsEvidence resource

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Drugs and AlcoholResearching Social Work practice close up: using ethnographic and mobile methods to understand encounters between social workers, children and families.HarryFergusonauthorResearch into child and family social work has largely stopped short of getting close enough to practice to produce understandings of what goes on between social workers and service users. This is despite the known problems in social worker engagement with children in cases where they have died. This paper outlines and analyses the methods used in a study of social work encounters with children and families on home visits where there were child protection concerns. It illustrates how mobile methods of walking and driving interviews were conducted with social workers on the way to and from home visits, and how the ethnography involved participant observation and audio-recordings of the interactions between social workers, children and parents in the home, revealing the talk, actions and experiences that occurred. Social workers often moved around the home, especially to interview children on their own in their bedrooms, and the paper shows how ways were found to stay close enough to observe these sensitive encounters within families' most intimate spaces, while ensuring the research remained ethical. Ethnographic and mobile methods produce vital data that advance new understandings of everyday social work practices and service users' experiences and of dynamics that are similar to breakdowns in practice that have occurred in child death cases.Health services, drugs and alcohol researchFamily supportSocial servicesResearch and evaluation methodQualitative studySocial workerUnited Kingdom2017-10OxfordEvidence resource

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Drugs and AlcoholImprovement knowledge and skills guide. Development Assessment Tool for all staff.Health information and educationOrganisational developmentWorkforce / staff skills and trainingInformation use and impactInformation transfer from research to practiceDrug or health care workerDoctorNursePrevention workerSocial workerIreland2017-10Health Service ExecutiveReport

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Drugs and AlcoholHealth Matters: preventing ill health from alcohol and tobacco use.AlcoholAlcohol usePatient care managementHealth care deliveryDrug or health care workerNursePrevention workerUnited Kingdom2017-10Public Health EnglandEvidence resource

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Drugs and AlcoholRole of nurses in alcohol and drug treatment services.Alcohol useCare by type of problemHealth care deliveryDrugs and alcohol disorder treatment unitDrug or health care workerNurseUnited Kingdom2017-10Public Health EnglandEvidence resource

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Drugs and AlcoholDo we all agree what "good health care" looks like? Views from those who are "seldom heard" in health research, policy and service improvement.SaraRyanauthorJennyHislopauthorSueZieblandauthorContext: The aim of this study was to ask whether there are shared ideas about what good health care looks like that apply across different populations and conditions. Do priorities among "seldom heard" groups differ from mainstream views and, if so, how might we understand these differences? Design: Focus groups were recruited with the help of our study patient representatives. Participants discussed and prioritized a set of eight "core components" of good care. We recorded and transcribed the data for thematic analysis. Setting and participants: We recruited people who are seldom heard in health and policy research for separate focus group discussions (one each with illegal drug users, Irish Travellers, migrant workers, young men and learning disabled people). We also ran a reference group of educated, older adults and an online group with people with long-term conditions. Results: There were few differences in what participants thought was important in health care but considerable differences in their expectations that they might personally receive good care. Differences related to participants' previous experiences. The drug users group reported particularly poor experiences and low expectations of good care. Discussion: Differences in what is regarded as an entitlement or privilege in health care underline the persistence of structural and relational differences in how services are experienced. While we can be reassured that core aspects of care are similarly prioritized across different patient groups, including those who are seldom heard, a more intractable challenge remains: how to provide equitable health care for marginalized groups in an unequal society.Patient care managementPatient attitude toward treatmentMental health careHealth care deliveryHealth care quality controlDrug userDrug or health care workerDoctorNurseUnited Kingdom2017-10WileyEvidence resource

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Drugs and AlcoholWHO alcohol brief intervention training manual for primary care.Alcohol contributes significantly to the disease and mortality burden in the WHO European Region, and primary health care systems play an important role in reducing the impact of harmful alcohol use. Screening and brief interventions (SBIs) for alcohol are an evidence-informed approach to addressing the needs of the many patients presenting in primary care who may benefit from reducing their alcohol consumption. This manual provides information to plan training and support for primary care practitioners to confidently deliver SBI for alcohol problems to their patients. The manual outlines the background and evidence base for SBI, and gives practical advice on establishing an implementation programme as well as detailed educational materials to develop the knowledge and skills of participants in organized training sessions. Unit 1. Introduction, course overview and group agreement p.22 Unit 2. Attitudes to alcohol p.26 Unit 3. Impact, consumption and harms of alcohol p.34 Unit 4. ABIs: goals, skills and practice change .p.44 Unit 5. Beginning a conversation about alcohol p.53 Unit 6. Screening and feedback using AUDIT p.57 Unit 7. Brief intervention core skills .p.68 Unit 8. Brief interventions – practice session p.77 Post training materials - Evaluation and monitoring p.93AlcoholAlcohol dependencePsychosocial treatment methodBrief interventionIdentification and screening for drugs and alcohol usePatient care managementCommunity-based treatment (primary care)Drug or health care workerDoctorNursePrevention workerSocial worker2017-10WHO Regional Office for EuropeEvidence resource

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Drugs and AlcoholDrug Matrix cell B1: practitioners - reducing harm.Drugs and alcohol use harm reductionPatient care managementPatient attitude toward treatmentProvider attitude toward treatmentHealth care deliveryHarm reduction policyDrug or health care workerDoctorNurseCounsellor / TherapistSocial worker2017-09Drug and Alcohol FindingsEvidence resource

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Drugs and AlcoholWhen parents take drugs.This booklet is intended for use by anyone talking with young people about a parent or carer’s drug or alcohol use, to help them understand and come to terms with their situation. Professionals – such as teachers, youth workers and health workers – who may come into contact with young people who they know, or suspect, are affected by the drug and/ or alcohol use of one, or both, of their parents may find it particularly useful. It is intended to be a tool by which a young person can be encouraged to discuss their life and their feelings and be reassured that there are people who can help with their situation. It should not be seen as an assessment tool - nor as a substitute for professional intervention – but as a source of support for the young person. Each page contains scenarios or prompts to help direct the young person to think about some of the issues they are facing, whilst the boxes across the bottom contain information and suggestions to help the adult reader facilitate the discussion. Section 1 – For adults • How to use this booklet • What are drugs • Effects on young people • What a young person might be going through • Assessing the risks • What the law says • The United Nations Convention on the • Rights of the Child • Resources Section 2 – for 4-10 year olds • All about drugs • I feel... • What’s going on? • I feel better • Mum and dad • My life • My future Section 3 – for 11-15 year olds • All about drugs • I feel ****! • What’s going on? • Feeling better • What mum and dad might be going through • My life • My futureFamily supportParental supportRole of grandparentParent-child relationsDrug or health care workerSocial workerChild of drugs and alcohol userParentUnited Kingdom2017-08AdfamEvidence resource

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Drugs and AlcoholImproving clinical responses to drug-related deaths. A summary of best practice and innovations from drug treatment providers.Drugs and alcohol poisoning (overdose)Drugs and alcohol use harm reductionDrugs and alcohol related mortality / deathDrug or health care workerDoctorNurse2017-08Collective Voice and the NHS Substance Misuse Provider AllianceEvidence resource

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Drugs and AlcoholHepatitis C screening. National clinical guideline no. 15. Summary.This Summary National Clinical Guideline is relevant to all healthcare professionals, healthcare managers and policy makers working with those at increased risk of hepatitis C virus (HCV) infection. The guideline will also be of value to both statutory and voluntary bodies providing services to those groups at increased risk of HCV infection. It may also be used by those with HCV or in a risk group for HCV and by members of the public. Hepatitis C virus (HCV) is a major cause of liver disease worldwide. Globally, it is estimated that there are 115 million people who have had HCV infection, and 80 million with chronic infection. Transmission of HCV occurs through contact with the blood of an infected person. Risk factors for HCV differ globally. In developed countries like Ireland, injecting drug use (IDU) is the major risk factor. (3.1.4 People who use unprescribed or illicit drugs - page 15)Hepatitis CCommunicable disease controlPatient care managementHealth care deliveryIntravenous / injecting drug userDrug or health care workerDoctorNurse2017-08Department of HealthReport

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Drugs and AlcoholThe effectiveness of interventions related to the use of illicit drugs: prevention, harm reduction, treatment and recovery. A ‘review of reviews’.GeoffBatesauthorLisaJonesauthorMadeleineCochraneauthorMarissaPendleburyauthorHarrySumnallauthorProblem drugs and alcohol useDrugs and alcohol recoveryDrugs and alcohol disorder treatment methodAlternative medical treatmentPsychosocial treatment methodTreatment outcomeDrugs and alcohol preventionDrugs and alcohol use harm reductionPrevention outcomeUniversal preventionTargeted preventionSchool-based preventionCommunity-based preventionPrevention approachPatient care managementTreatment factorsCommunity-based treatment (primary care)Adolescent / youth (teenager / young person)DoctorPrevention workerInternational aspects2017-07Health Research BoardReport

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Drugs and AlcoholStrengths-based social work practice with adults.Report based on a workshop commissioned by the Department of Health and held at the Social Care Institute for Excellence in January 2017. This report is for social workers, senior leaders of adult social care, and people who use the services. It looks at what ‘strengths-based social work’ with adults, individuals, families and communities means for practitioners and people using the services. ‘Strengths-based practice is a collaborative process between the person supported by services and those supporting them, allowing them to work together to determine an outcome that draws on the person’s strengths and assets. As such, it concerns itself principally with the quality of the relationship that develops between those providing support and those being supported, as well as the elements that the person seeking support brings to the process. Working in a collaborative way promotes the opportunity for individuals to be co-producers of services and support rather than solely consumers of those services.Health care deliverySocial supportCollaboration (co-operation)Social servicesSocial workerUnited Kingdom2017-07Department of HealthEvidence resource

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Drugs and AlcoholImplementing a tobacco-free hospital campus in Ireland: lessons learned.DMcArdleauthorZubairKabirauthorTobacco (cigarette smoking)Health information and educationHealth care deliveryHealth care programme or facilityDrug or health care workerIreland2017-07SpringerArticle

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Drugs and AlcoholPregabalin: Guidance for people working with Pregabalin users.Pregabalin is a drug originally used to prevent focal seizures or ‘fits’ in people with epilepsy. It is one of the gabapentinoid family of medicines that also includes Gabapentin. It comes in different strengths from 25mg to 300mg capsules. Who this booklet is aimed at? This is primarily for people who work with people who use Pregabalin that is not prescribed to them. However it may also be useful to people who overuse their prescribed amount, people who take Pregabalin that isn’t prescribed for them or for people who care about a Pregabalin user. (If you are under 16 you should only use this booklet with support from a suitably qualified youth worker, social worker or addictions worker.)New (novel) psychoactive substancesPrescription drug (medicine / medication)Drug or health care workerPrevention workerIrelandNorthern Ireland2017-07ExternReport

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Drugs and AlcoholBetter care for people with co-occurring mental health and alcohol/drug use conditions. A guide for commissioners and service providers.EmmaChristieauthorIt is very common for people to experience problems with their mental health and alcohol/drug use (co-occurring conditions) at the same time. Research shows that mental health problems are experienced by the majority of drug (70%) and alcohol (86%) of alcohol users in community substance misuse treatment. Death by suicide is also common, with a history of alcohol or drug use being recorded in 54% of all suicides in people experiencing mental health problems. Other evidence tells us that people with co-occurring conditions have a heightened risk of other health problems and early death. We also know that in spite of the shared responsibility that NHS and local authority commissioners have to provide treatment, care and support, people with co-occurring conditions are often excluded from services. This Public Health England (PHE) guide, developed with the support of NHS England, seeks to address this disparity. It should be used by the commissioners and providers of mental health and alcohol and drug treatment services, to inform the commissioning and provision of effective care for people with co-occurring mental health and alcohol/drug use conditions. It also has relevance for all other services that have contact with people with co-occurring conditions, including people experiencing mental health crisis. It is an action for PHE from the Crisis Care Concordati national action plan. It has been co-produced with members of the expert reference group for co-existing substance misuse with mental health issues, and in consultation with experts through experience, service providers, practitioners, commissioners and policy leads. It supports implementation of the Five Year Forward View for Mental Health, including current and forthcoming development of a comprehensive set of evidence-based treatment pathways (EBTPs). It aims to support local areas to commission timely and effective responses for people with co-occurring conditions. It encourages commissioners and service providers to work together to improve access to services which can reduce harm, improve health and enhance recovery, enabling services to respond effectively and flexibly to presenting needs and prevent exclusion.Dual diagnosis (comorbidity)Drugs and alcohol related mental disorderMental health careHealth care deliveryDrug or health care workerDoctorNurseSocial workerUnited Kingdom2017-07Public Health EnglandEvidence resource

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Drugs and AlcoholDrug misuse and dependence. UK guidelines on clinical management.Contents Chapter 1: Introduction 9 Chapter 2: Essential elements of treatment provision 15 2.1 Key points 15 2.2 Assessment, planning care and treatment 15 2.3 Delivery of treatment 27 2.4 Drug testing 28 2.5 General health assessment at presentation and in treatment 31 2.6 Effective communication with primary and secondary care services 35 2.7 Organisational factors for effective drug treatment 35 2.8 Intimate partner violence and domestic abuse 43 2.9 Planning and contracting or commissioning services 44 Chapter 3: Psychosocial components of treatment 47 3.1 Key points 47 3.2 Introduction 47 3.3 Core elements underpinning effective delivery 51 3.4 Making psychosocial interventions effective 52 3.5 Interventions focused on social network and family, friends and carers 56 3.6 Medication and psychosocial interventions 57 3.7 Delivering psychosocial interventions 58 3.8 Resources and further reading 81 3.9 References 81 Chapter 4: Pharmacological interventions 83 4.1 Key points 83 4.2 Prescribing 84 4.3 Choosing an appropriate opioid substitute 88 4.4 Induction onto methadone and buprenorphine substitution treatment 90 4.5 Supervised consumption 101 4.6 Assessing and responding to progress and failure to benefit 104 4.7 Opioid maintenance prescribing 110 4.8 Opioid detoxification 115 4.9 Naltrexone for relapse prevention 118 4.10 Pharmacological management of dependence on other drugs 119 4.11 Resources and further reading 124 4.12 References 125 Chapter 5: Criminal justice system 127 5.1 Key points 127 5.2 Introduction 128 5.3 Criminal justice systems in the community 130 5.4 Prisons and other secure environments 133 5.5 References 160 Chapter 6: Health considerations 163 6.1 Key points 163 6.2 Blood-borne viruses and other infections 163 6.3 Preventing drug-related deaths 174 6.4 Naloxone 178 6.5 Alcohol in drug treatment 183 6.6 Smoking and respiratory function 187 6.7 Oral health 190 6.8 References 194 Chapter 7: Specific treatment situations and populations 197 7.1 General key points 197 7.2 Pain management 197 7.3 Dependence on prescribed and over-the-counter opioids 205 7.4 Misuse of or dependence on gabapentinoids 208 7.5 Hospitalisation 209 7.6 Pregnancy and neonatal care 220 7.7 New psychoactive substances and club drugs 225 7.8 Image and performance enhancing drugs 229 7.9 Coexisting problems with mental health and substance use 231 7.10 Young people 240 7.11 Older people 247 7.12 References 252 Annexes 255 A1: Working group members and other contributors 257 A2: Governance 263 A3: Marketing authorisations 271 A4: Writing prescriptions 277 A5: Interactions 293 A6: Travelling abroad with controlled drugs 303 A7: Drugs and driving 305 A8: Glossary 311State of healthDrugs and alcohol disorder treatment methodDrugs and alcohol replacement method (substitution)Methadone maintenancePsychosocial treatment methodTreatment outcomeDrugs and alcohol use harm reductionCommunicable disease controlHealth promotionPatient care managementTreatment factorsHealth care deliveryCommunity-based treatment (primary care)Health care quality controlDrug userDrug or health care workerDoctorNurseUnited Kingdom2017-07Department of HealthEvidence resource

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Drugs and AlcoholPeople with learning disabilities: making reasonable adjustments. Guidance: substance abuse.Coping skillsCognitionrisk factorsDrugs and alcohol use harm reductionSocial supportDrug or health care workerSocial workerEngland2017-06-23Public Health EnglandEvidence resource

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Drugs and AlcoholAlcohol matrix cell C5: Management/supervision - safeguarding the community.AlcoholPatient attitude toward treatmentProvider attitude toward treatmentHealth care programme or facilityCommunity-based treatment (primary care)Crime preventionOrganisational developmentWorkforce / staff skills and trainingDrug or health care workerCounsellor / TherapistSocial worker2017-06Drug and Alcohol FindingsEvidence resource

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Drugs and AlcoholAlcohol matrix cell D5: Organisational functioning - safeguarding the community.AlcoholCommunity needs assessmentCrime preventionCommunity anti-crime or legal assistance programmeOrganisational developmentWorkforce / staff skills and trainingDrug or health care workerNurseSocial worker2017-06Drug and Alcohol FindingsEvidence resource

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Drugs and AlcoholOlder people with drug problems in Scotland. A mixed methods study exploring health and social support needs.CatrionaMathesonauthorDavidLiddellauthorEmmaHamiltonauthorJasonWallaceauthorState of healthNeeds assessmentSocial supportSocial servicesElderly / Older personSocial workerScotland2017-06Scottish Drugs ForumEvidence resource

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Drugs and AlcoholLiver disease. Quality standard.Drugs and alcohol effects and consequencesPhysical healthPatient care managementHealth care deliveryDrug or health care workerDoctorUnited Kingdom2017-06National Institute for Health and Care ExcellenceEvidence resource

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Drugs and AlcoholAlcohol matrix cell B5: Practitioners - safeguarding the community.AlcoholAttitude toward drugs and alcohol addict or userPatient attitude toward treatmentProvider attitude toward treatmentDrug or health care workerDoctorNurseCounsellor / TherapistSocial worker2017-05Drug and Alcohol FindingsEvidence resource

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Drugs and AlcoholEMCDDA Best practice portal.The Best practice portal is a resource for professionals, policymakers and researchers in the areas of drug-related prevention, treatment, harm reduction and social reintegration. The portal concentrates on illicit drugs and polydrug use and has a clear European focus. It is continuously updated as information and research on interventions emerges. You can find the latest evidence (what works and what doesn't work) - guidelines, standards and tools (instruments and questionnaires). ‘Best practice is the best application of available evidence to current activities in the drugs field. • underlying evidence should be relevant to the problems and issues affecting those involved(professionals, policymakers, drug users, their families); • methods should be transparent, reliable and transferable and all appropriate evidence should be considered in the classification process; • experience in implementation, adaptation and training should be systematically collected and made available; • contextual factors should be studied by modelling different prevalence levels so as to assess the impact of an intervention on the population; and • evidence of effectiveness and feasibility of implementation should both be considered for the broader decision-making process.'Drugs and alcohol disorder treatment methodTreatment outcomeHealth services, drugs and alcohol researchDrugs and alcohol preventionDrugs and alcohol use harm reductionPrevention outcomePrevention approachHealth care deliveryHealth care quality controlInformation transfer from research to practiceRecommendations or guidelinesResearch outcomeDrug or health care workerDoctorNursePrevention workerSocial worker2017-05European Monitoring Centre for Drugs and Drug AddictionEvidence resource

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Drugs and AlcoholNovel Psychoactive Substances: important information for health professionals.HarrySumnallauthorIanHamiltonauthorMarkMonaghanauthorNovel psychoactive substances (NPS; also known as new psychoactive substances or popularly, although erroneously, as ‘legal highs’) is the name given to drugs that are newly synthesised or newly available, and which do not fall under the control of United Nations Drug Conventions. These drugs exist as a result of advances in academic, industrial, and psychonautic chemistry and are used for many of the same reasons given for traditional illegal drugs such as cannabis, ecstasy, and heroin. However, many NPS are not detected by routine forensic screens, and so are relatively popular in secure settings such as prisons, or in professions that are subject to random drug screening programmes..........Drugs and alcohol effects and consequencesNew (novel) psychoactive substancesDrug or health care workerDoctorNursePrevention workerSocial worker2017-03-03Minervation LtdEvidence resource

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Drugs and AlcoholAlcohol Matrix cell B4: Practitioners - psychosocial therapies.AlcoholPsychosocial treatment methodTreatment outcomePatient care managementTreatment factorsPatient attitude toward treatmentProvider attitude toward treatmentWorkforce / staff skills and trainingDrug or health care workerNurseCounsellor / Therapist2017-03Drug and Alcohol Findings and the Substance Misuse Skills ConsortiumEvidence resource

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Drugs and AlcoholNew psychoactive substances: Current health-related practices and challenges in responding to use and harms in Europe.AlessandroPironaauthorAlessandraBoauthorDagmarHedrichauthorMaricaFerriauthorNadinevan GelderauthorIsabelleGiraudonauthorLindaMontanariauthorRolandSimonauthorJaneMounteneyauthorBACKGROUND: The availability of new psychoactive substances (NPS) in Europe has rapidly increased over the last decade. Although prevalence levels of NPS use remain low in the general European population, there are serious concerns associated with more problematic forms of use and harms in particular populations and settings. It has thus become a priority to formulate and implement effective public health responses. However, considerable knowledge gaps remain on current practices as well as on the challenges and needs of European health professionals who are responding to use and harms caused by these substances. The aim of this study was to explore current health responses to NPS, and highlight key issues in order to inform planning and implementation of adequate responses. METHODS: This scoping study was based on a targeted multi-source data collection exercise focusing on the provision of health and drug interventions associated with NPS use and harms, in selected intervention settings across Europe. RESULTS: Findings revealed that in the absence of specific evidence, health professionals across most intervention settings rely primarily on acquired expertise with traditional drugs when addressing NPS-related harms. This study also identified a gap in the availability and access to timely and reliable information on NPS to users and health professionals. Health professionals in sexual health settings and custodial settings in contact with certain risk groups reported particular challenges in responding to NPS-related harms. CONCLUSION: Immediate investments are required in expanding substance identification capabilities, competence building among professionals and dissemination of risk information among relevant stakeholders. The risks of neglecting under-served risk populations and failure to address the information needs of health professionals and users on NPS harms in a context of rapid changing drug markets in Europe may have unforeseeable consequences at societal level.New (novel) psychoactive substancesState of healthPublic healthDrugs and alcohol use harm reductionDrug or health care workerEuropeIreland2017-02ElsevierArticle

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Drugs and AlcoholCase management manual 2015Contents Section 1 Screening and Assessment Protocol p..2 AUDIT screening tool. p...4 DUDIT screening tool. p...7 Initial Assessment protocol Cork/Kerry p..10 Service Users Information & Consent Form p..12 Initial Assessment Form p..15 Comprehensive Assessment Protocol & Form. p..23 Section 2 Referral Protocol. p..38 Referral Form p..40 Section 3 Interagency Care Plan Protocol p.. 43 Interagency Care Plan Form p..45 Interagency Care Plan Review Form p..48 Interagency Care Plan – Case Manager Transfer Form p..49 Section 4 Keyworking, Care Planning & Case Management Local Protocols. p..51 Section 5 Confidentiality and Information Sharing Protocol p..56 Section 6 Gaps and Blocks Protocol p..61 Gaps and Blocks Reporting Form (NDRIC level) p..63 Gaps and Blocks Reporting Form (Local level p..65 Appendices: Appendix 1: Service User Information Sheet p.. 67 Appendix 2: Introduction Letter to external services explaining Case Management.. p..68 Appendix 3: Individual Care Plan Template. p..69 Appendix 4: Interagency Case Meeting Step by Step summary. p..70 Appendix 5: Chairing Skills: Dealing with Difficult Group Dynamics p..71 Appendix 6: Case management Training participants Cork/Kerry p..74 Appendix 7: Referral & Assessment guidelines to Tier 4. p..77 Appendix 8: Needle Exchange Service s p..82 Appendix 9 Monitoring. p..83Health care deliveryDrug or health care workerCorkKerry2017-01Cork & Kerry Drug & Alcohol ServicesReport

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Drugs and AlcoholHRB drug and alcohol evidence review on case management.BrianGalvinauthorGeneral treatment method conceptsTreatment outcomePatient care managementTreatment factorsHealth care deliveryWorkforce / staff skills and trainingDrug userDrug or health care worker2017-01Health Research BoardArticle

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Drugs and AlcoholSpecialist substance misuse services for young people. A rapid mixed methods evidence review of current provision and main principles for commissioning.In April 2013, commissioning drug and alcohol misuse treatment services in the United Kingdom became the responsibility of local authorities. At that point local authorities were given greater autonomy to develop their own approaches to meet local need and the previously ring-fenced budget for young people’s specialist substance misuse services became part of the wider local authority public health grant. Public Health England (PHE) commissioned The Children’s Society to undertake scoping research in early 20161, to understand some of the opportunities and challenges currently facing those now responsible for commissioning and delivering young people’s specialist substance misuse services and to outline some critical good practice principles. The findings reflect a snapshot of commissioning and provision in England, and do not constitute an exhaustive or systematic national review. Those interviewed were asked about: local commissioning practices and common service models; the evidence used in commissioning decisions around best practice; emerging local trends in substance misuse; and current opportunities and challenges for commissioning. Young service users were invited to share their views on what they believe should constitute core components of a young person-centered service that responds to their needs, makes them likely to engage effectively and results in positive outcomes for them. Four core commissioning principles have been developed, based on the findings, research and evidence based guidelines, for the commissioning and provision of specialist substance misuse provision for young people. The document is designed to provide prompts around some core principles for consideration when local authorities are commissioning specialist substance misuse provision, but is not intended to be a comprehensive commissioning guide.Prevention programme or serviceHealth care deliverySocial supportOrganisational developmentAdolescent / youth (teenager / young person)Drug or health care workerSocial workerUnited Kingdom2017-01Public Health EnglandEvidence resource

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Drugs and AlcoholAlcohol Matrix cell C3: Management/supervision - medical treatment.AlcoholProvider attitude toward treatmentHealth care deliveryHealth care administrationOrganisational developmentWorkforce / staff skills and trainingDrug or health care workerDoctor2016-12Drug and Alcohol Findings and the Substance Misuse Skills ConsortiumEvidence resource

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Drugs and AlcoholHow does older people’s drinking appear in the daily work of home care professionals?RiittaKoivulaauthorChristofferTigerstedtauthorAnniVilkkoauthorKristiinaKuussaariauthorSatuPajalaauthorAIMS - In this article the authors ask how the alcohol use of elderly home care clients affects the daily work of home care professionals and how the professionals act to support the drinking client. METHODS - Semi-structured interviews with 10 home care professionals were conducted from December 2014 to February 2015 in the Helsinki metropolitan area of Finland. Everyday situations during home visits related to the clients’ alcohol use were analysed according to modalities of agency of the home care professionals. RESULTS - The results focus on three themes raised in the interviews: supporting life management of the client, the lack of qualifications in tackling clients’ drinking and the need for multi-professional collaboration. Intoxicated clients complicated the home care nurses’ work and obstructed the implementation of recommendations set out to guide the professionals’ operations. Care work with alcohol-using clients was particularly demanding, and the professionals were concerned about not having enough training in how to encounter elderly clients’ drinking. Multi-professional collaboration with substance abuse services and emergency department personnel was called for to remedy this problem. CONCLUSIONS - More extensive and detailed research is needed for a better picture of how clients’ drinking influences home care nurses’ working conditions and what kind of skills nurses need in different alcohol-related situations. Such research would have the potential to benefit clients and improve the well-being of the employees.Alcohol consumptionDrugs and alcohol effects and consequencesAlcoholAlcohol intoxicationPatient care managementSocial supportElderly / Older personDrug or health care workerNurseFinland2016-12De GruyterEvidence resource

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Drugs and Alcohol‘What works’ in drug education and prevention?FranWarrenauthorThis literature review provides background on what is meant by prevention and education and discusses the evidence base. The evidence of effectiveness for different approaches used in schools and other components necessary for effective drug prevention and education in schools is presented. The effectiveness of drug education and prevention beyond the school setting is then considered, alongside the evidence to support peer led interventions and specific programmes for vulnerable young people. Specific manualised and licensed prevention programmes are considered and some of the issues and challenges involved in implementing these programmes in different contexts is discussed. The evidence for ineffective approaches to drug prevention is highlighted and lastly recommendations from the literature for policy makers are set out, alongside some thoughts on the implications of this review for drug education and prevention in Scotland, in particular the need to map prevention activity for young people being delivered in Scotland.Drugs and alcohol preventionPrevention outcomeSchool-based preventionCommunity-based preventionPrevention through information and educationAOD educationAdolescent / youth (teenager / young person)Drug or health care workerPrevention workerSocial workerScotland2016-12Scottish GovernmentEvidence resource

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Drugs and AlcoholAlcohol Matrix cell B3: Practitioners - medical treatment.AlcoholTreatment factorsPatient attitude toward treatmentProvider attitude toward treatmentHealth care deliveryDrug or health care workerDoctorNurse2016-11Drug and Alcohol Findings and the Substance Misuse Skills ConsortiumEvidence resource

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Drugs and AlcoholPreventing children and young people’s mental health and substance use problems.This briefing paper is part of a series produced by Mentor ADEPIS on alcohol and drug education and prevention, for teachers and practitioners. It intends to provide teachers, educators and the wider school workforce with practical guidelines on how to prevent children and young people from developing mental health problems as a result of alcohol and drug misuse.Mental healthDrugs and alcohol preventionTargeted preventionSchool-based preventionYouth-club / cafe based preventionRole of childChildAdolescent / youth (teenager / young person)Prevention workerUnited Kingdom2016-10MentorEvidence resource

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Drugs and AlcoholQuality standard frameworks for community treatment.The standards were developed after consultation with the sector, and have been piloted by ten services, which used them to examine and assess how they support people into and through recovery, bringing together the relevant evidence to demonstrate the good work and then being interviewed by us. This represents a chance for services to both contribute to the overall quality of the treatment sector, and assess the quality of two or three vital aspects of their organisation.Drugs and alcohol recoveryTreatment outcomeTreatment factorsRehabilitationHealth care deliveryCommunity-based treatment (primary care)Health care quality controlOrganisational developmentDrug or health care workerUnited Kingdom2016-10Recovery PartnershipEvidence resource

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Drugs and AlcoholAlcohol Matrix cell B2: Practitioners; generic and cross-cutting issues.Alcohol consumptionAlcoholAttitude toward drugs and alcohol addict or userTreatment outcomeTreatment factorsPatient attitude toward treatmentProvider attitude toward treatmentDrug or health care workerDoctorNursePrevention workerSocial worker2016-09Drug and Alcohol FindingsEvidence resource

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Drugs and AlcoholAlcohol Matrix cell D2: Organisational functioning; Generic and cross-cutting issues.AlcoholPatient care managementHealth care deliveryHealth care quality controlOrganisational developmentWorkforce / staff skills and trainingDrug or health care worker2016-09Drug and Alcohol FindingsEvidence resource

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Drugs and AlcoholHow effective are brief interventions in reducing alcohol consumption: do the setting, practitioner group and content matter? Findings from a systematic review and metaregression analysis.LucyPlattauthorGJMelendez-TorresauthorAmyO'DonnellauthorJenniferBradleyauthorDorothyNewbury-BirchauthorEileenKanerauthorCharlotteAshtonauthorAlcohol consumptionAlcoholPsychosocial treatment methodBrief interventionHealth care deliveryDrug or health care workerNurse2016-08BMJ PublishingEvidence resource

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Drugs and AlcoholShared measurement of personal outcomes in recovery.BrianGalvinauthorDrugs and alcohol recoveryTreatment outcomePrevention outcomeHealth care deliveryDrug userDrug or health care workerIreland2016-08Health Research BoardArticle

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Drugs and AlcoholDelivering alcohol IBA in housing, probation and social work settings: opportunities and constraints.BetsyThomauthorRachelHerringauthorMariannaBayleyauthorTrishHafford-LetchfieldauthorAlcohol consumptionAlcoholPsychosocial screening and diagnostic methodBrief interventionIdentification and screening for drugs and alcohol useHomeless servicesProbation or paroleSocial servicesDrug or health care workerSocial workerHomeless personUnited Kingdom2016-06Alcohol Research UK and Drug and Alcohol Research Centre, Middlesex UniversityEvidence resource

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Drugs and AlcoholAlcohol Matrix cell B1: Practitioners - screening and brief intervention.AlcoholAlcohol dependenceMedical screening and diagnostic methodPsychosocial screening and diagnostic methodBrief interventionIdentification and screening for drugs and alcohol usePatient care managementemergency careCommunity-based treatment (primary care)Drug or health care workerDoctorNurseSocial worker2016-06Drug and Alcohol FindingsEvidence resource

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Drugs and AlcoholAlcohol Matrix cell C1: Management/supervision - screening and brief intervention.AlcoholAlcohol dependenceMedical screening and diagnostic methodPsychosocial screening and diagnostic methodBrief interventionIdentification and screening for drugs and alcohol useHealth care deliveryWorkforce / staff skills and trainingDrug or health care worker2016-06Drug and Alcohol FindingsEvidence resource

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Drugs and AlcoholCommunity based low threshold substance use services: practitioner approaches and challenges.SarahMortonauthorLauraO'ReillyauthorLow threshold services are typically provided within community or city settings, either by statutory or community organisations. Services may be staffed by counsellors, key workers or support workers who would normally seek to engage informally with clients and deliver brief, harm reduction focused interventions. In addition, low threshold services often depend on volunteers for staffing and provide new drugs workers who may require high levels of supervision with an entry point into drugs work. A range of issues have emerged in relation to low threshold service provision including high volumes of clients accessing a service, variation in approach and aims of low threshold services and health and safety implications for workers and clients in regard to service users being severely intoxicated, using substances on the premises or overdosing.Drugs and alcohol use behaviourMental healthCommunity-based treatment (primary care)HomelessnessDrug or health care workerCounsellor / TherapistIreland2016-06Ballymun Youth Action ProjectReport

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Drugs and AlcoholFrequent attenders to accident and emergency departments: a qualitative study of individuals who repeatedly present with alcohol-related health conditions.JoanneNealeauthorTomParkmanauthorEdDayauthorColinDrummondauthorKey findings • People who frequently attend Accident and Emergency (A&E) departments for alcohol-related reasons tend to experience alcohol dependence associated with multiple and complex needs, but also report diverse patterns of drinking and other substance use, and varied health and social problems. • Although A&E staff are generally sympathetic to the needs of people with complex drinking and related problems, they do not have the resources or training to provide the kind of personalised support that people who frequently attend A&E for alcohol-related reasons often need. • Assertive outreach – a treatment model that offers intensive, individualised, caseworker support for patients in the community – seems to offer good potential for helping people who frequently attend A&E for alcohol-related reasons.Drugs and alcohol effects and consequencesAlcoholAttitude toward drugs and alcohol addict or userState of healthAlcohol dependencePatient care managementemergency careDrug or health care workerDoctorNurseSocial workerUnited Kingdom2016-05Alcohol research UKEvidence resource

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Drugs and AlcoholAlcohol Matrix cell A1: Interventions - screening and brief intervention.AlcoholMedical screening and diagnostic methodPsychosocial screening and diagnostic methodBrief interventionIdentification and screening for drugs and alcohol usePatient care managementemergency careCommunity-based treatment (primary care)Drug or health care worker2016-05Drug and Alcohol Findings and the Substance Misuse Skills ConsortiumEvidence resource

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Drugs and AlcoholImproving the physical health of people with serious mental illness. A practical toolkit.Physical healthMental healthMental health careHealth care deliveryHealth care quality controlDrug or health care workerDoctorNurseEngland2016-05NHS EnglandEvidence resource

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Drugs and AlcoholThe effectiveness of social work with adults. A systematic scoping review.JoMoriartyauthorJillManthorpeauthorThis report is based on a scoping review into the effectiveness of social work with adults undertaken to help inform the work of the Chief Social Worker for Adults. The Chief Social Worker for Adults is responsible for leading the reform of adult social work at government level in England. It is based on systematic searches of a number of electronic bibliographic databases, websites, and reference harvesting the bibliographies of key published studies in order to identify material that had not come up in the searches. ‘Effectiveness’ refers to how well a particular intervention, approach, or policy performs under ‘real world’ conditions. However, it is accepted that definitions of effectiveness depend upon what is being measured and who is doing the measuring. The review took a broad approaching to defining effectiveness, including cost effectiveness, impact on service users and carers (for example, changes to quality of life), and user and carer views. • Overall, the review concluded that, although the evidence base for social work with adults is mixed and uneven, the results are broadly positive. • Social workers’ effectiveness seems to rest most on their ability to combine a number of roles, including assessment, local knowledge, and being able to provide counselling and/or ongoing support. • The evidence base for studies about care management and health care social work appears to be largest. • There is considerable satisfaction with palliative care social workers among service users and carers but there is evidence of unmet demand. • We seem to know least about effectiveness of social work with adults with learning disabilities. • We need to know more about the inter relationships between structural arrangements, workload, worker satisfaction and effectiveness.Health care deliveryHealth care quality controlSocial servicesDrug or health care workerSocial worker2016-03King’s College LondonEvidence resource

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Drugs and AlcoholRecovery-focused care planning and coordination in England and Wales: a cross-national mixed methods comparative case study.AlanSimpsonauthorBenHanniganauthorMichaelCoffeyauthorSallyBarlowauthorRachelCohenauthorAledJonesauthorJitkaVšetečkováauthorAlisonFaulknerauthorAlexandraThorntonauthorMartinCartwrightauthorBACKGROUND: In the UK, concerns about safety and fragmented community mental health care led to the development of the care programme approach in England and care and treatment planning in Wales. These systems require service users to have a care coordinator, written care plan and regular reviews of their care. Processes are required to be collaborative, recovery-focused and personalised but have rarely been researched. We aimed to obtain the views and experiences of stakeholders involved in community mental health care and identify factors that facilitate or act as barriers to personalised, collaborative, recovery-focused care. METHODS: We conducted a cross-national comparative study employing a concurrent transformative mixed-methods approach with embedded case studies across six service provider sites in England and Wales. The study included a survey of views on recovery, empowerment and therapeutic relationships in service users (n = 448) and recovery in care coordinators (n = 201); embedded case studies involving interviews with service providers, service users and carers (n = 117) and a review of care plans (n = 33). Quantitative and qualitative data were analysed within and across sites using inferential statistics, correlations and framework method. RESULTS: Significant differences were found across sites for scores on therapeutic relationships. Variation within sites and participant groups was reported in experiences of care planning and understandings of recovery and personalisation. Care plans were described as administratively burdensome and were rarely consulted. Carers reported varying levels of involvement. Risk assessments were central to clinical concerns but were rarely discussed with service users. Service users valued therapeutic relationships with care coordinators and others, and saw these as central to recovery. CONCLUSIONS: Administrative elements of care coordination reduce opportunities for recovery-focused and personalised work. There were few common understandings of recovery which may limit shared goals. Conversations on risk appeared to be neglected and assessments kept from service users. A reluctance to engage in dialogue about risk management may work against opportunities for positive risk-taking as part of recovery-focused work. Research to investigate innovative approaches to maximise staff contact time with service users and carers, shared decision-making in risk assessments, and training designed to enable personalised, recovery-focused care coordination is indicated.Drugs and alcohol recoveryTreatment outcomeRisk assessmentTreatment factorsPatient attitude toward treatmentProvider attitude toward treatmentHealth care deliveryOrganisational developmentDrug or health care workerWalesEngland2016-03BioMed CentralArticle

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Drugs and AlcoholCapacity building & change management. A guide for community services.MeredithCarterauthorJaneMoretonauthorThere have been significant challenges in recent years in the not-for-profit sector. In particular, change is a constant along with increasing recognition of the ongoing need to examine and develop the capacity of our people and organisations. In this new manual VAADA has sought to provide the field with a resource which can be used widely across the not-for-profit sector and particularly in agencies delivering primary health and community care services. Not least of the current challenges faced by many agencies are funding constraints and increasing service demands. Consumers often present with a range of complex and co-existing issues. More and more both consumers and funders look to agencies to provide a holistic response to these issues. In addition increasingly they look to agencies to involve consumers, their families and carers in determining how their problems would best be managed. Strong partnerships between agencies to enhance capacity, enable best practice and deliver holistic responses to consumer needs are critical. This manual aims to equip agencies to meet these challenges. It offers useful strategies which are practical to implement. It also provides step by step guidance and templates to assist agencies to translate them into practice.Health care deliveryHealth care programme or facilityCommunity developmentOrganisational developmentWorkforce / staff skills and trainingDrug or health care workerAustralia2016-02Victorian Anti & Drug AssociationEvidence resource

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Drugs and AlcoholUsing research evidence: a practice guide.JonathanBreckonauthorIsobelRobertsauthorResearch evidence can help you understand what works, where, why and for whom. It can also tell you what doesn’t work, and you can avoid repeating the failures of others by learning from evaluations of unsuccessful programmes. Evidence also challenges what we might think is common sense. Whether it’s in a police station, a school classroom or the boardroom of a charity, evidence can help you make better decisions. It is helpful not only in frontline service-delivery, but also in creating smarter organisations Contents: Introduction 4 Section A: What is evidence-informed decision-making, and why focus on research? 6 Section B: When can evidence help you? 13 Section C: ‘Horses for courses’ – What evidence should you choose? 18 • Part 1: Different types of research methods, designs and approaches 20 • Part 2: How do you judge the quality of research? 29 Section D: Where should you look for evidence? 38 Section E: How should you communicate your findings? 46 Summary 49 Appendix 1: Rationales for evidence and types of evidence required for policymakers 50 Appendix 2: Experimental designs for evaluating complex interventions 51 Appendix 3: Guidance on evidence quality, designs and methods 52Workforce / staff skills and trainingInformation transfer from research to practicePolicy implications of researchResearch and evaluation methodDrug or health care workerDoctorNursePrevention workerSocial worker2016-01Nesta and Alliance for Useful EvidenceEvidence resource

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Drugs and AlcoholInclusion health: education and training for health professionals. Executive summary.JuneDavisauthorMaryLovegroveauthorThe concept of Inclusion Health is founded on the premise that not all UK citizens have access to the highest standards of healthcare. Meeting the health needs of a small group of socially excluded individuals and their communities remains a challenge. This population has poorer predicted health outcomes1 and a shorter life expectancy than the average population. The National Inclusion Health programme for England was launched in March 2010 as a cross-government programme led by the Department of Health. It provides a framework for driving improvements in health outcomes for socially excluded groups. The rationale for setting up this framework is to increase the understanding and visibility of the health needs and health outcomes of socially excluded groups. The framework will also ensure that the services which support this population continue to improve, including continuity of care and building capability and capacity. One key activity within the framework is to recognise the achievements of professionals in this field and to build connections across disciplines between health and social care.Inclusion and exclusionHomeless servicesDrug or health care workerPrevention workerSocial workerUnited Kingdom2016-01Department of HealthEvidence resource

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Drugs and AlcoholReport on the role of advocacy in health and social care services in Ireland.The cross-party report aims to explain the role of advocates in an Irish health service context; examines different models of advocacy; and makes some recommendations to improve access to advocacy services for Irish patients and users of social services. Some of the recommendations include: • The lack of statutory powers for advocates can prevent them from accessing or supporting vulnerable clients. Consideration should be given to commencing the relevant sections of the Citizens’ Information Act 2007 to resolve this issue. • The HSE should consider giving more formal recognition to the role of advocates who are working to support vulnerable clients. • Elected representatives have experienced difficulties making representations to hospitals and other health services on behalf of constituents, and these issues should be resolved. • The Committee supports moves to extend the remit of the Office of the Ombudsman to clinical cases. Ideally, there should be a single streamlined pathway for complaints in the Irish health service. The Committee supports the further development of the www.healthcomplaints.ie website to help achieve this. • Any new patient advocacy service should be independent of the Health Service Executive. Funding should be ring-fenced and independent of the service provider to support its activities and to ensure its independence. • A Code of Practice for advocacy services should be developed by agreement between key national stakeholders. This would ensure that all professional and voluntary advocates operate to the same ethical and legal standards.Health care deliveryHealth care quality controlAdvocacyDrug or health care workerIreland2016-01Houses of the OireachtasReport

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Drugs and AlcoholExploring the views of healthcare professionals on increasing smoking cessation advice for patients.SYHoauthorNGMcElvaneyauthorMBalfemauthorFrankDoyleauthorTobacco (cigarette smoking)HospitalDrug or health care workerDoctorNurseDublin2016Royal College of Surgeons of IrelandArticle

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Drugs and AlcoholA handbook for prison staff with focus on the prevention of ill-treatment in prison.JimMurdochauthorVaclavJirickaauthorIn Europe, the old adage that individuals are sent to prison as punishment rather than for punishment has now been supplemented by a further maxim: that prisoners retain all civil rights other than those that are incompatible with the very fact of loss of liberty. Prisoners retain their human rights, and the scope of these rights is increasing. For example, a plethora of decisions and judgments of the European Court of Human Rights has helped spell out the content of rights relating to communication with the outside world and exercise of the franchise. In Europe at least, prisons are changing in how the legal system engages with the treatment of prisoners. This text examines one particular aspect of this protection: the prohibition of ill-treatment in prison. It focuses upon what this prohibition entails, and the emergence of positive obligations and new expectations in respect of the responsibilities of prison services towards those entrusted to its care. It also examines the development of new obligations in respect of combating the impunity of those who use ill-treatment in places of detention. It seeks to provide a basic awareness of European standards, both in terms of legal obligations under the European Convention on Human Rights (ECHR) and in respect of standard-setting by allied bodies (in particular, by the European Committee for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT), but also by the Committee of Ministers of the Council of Europe). It also highlights examples of good practice in domestic systems that may be worthy of emulation elsewhere. Working in prisons is not without significant challenge. The intention is that this text will help those concerned with this area of public provision achieve a more humane and open service. In this regard, it seeks to help realisation of Rule 81(4) of the Committee of Ministers Recommendation Rec. R(2006)2 on the European Prison Rules. This provides that “The training of all staff shall include instruction in the international and regional human rights instruments and standards, especially by ECHR and the European Convention for the Prevention of Torture and Inhuman or Degrading Treatment or Punishment (CPT Convention), as well as in the application of the European Prison Rules.” This text is designed for practitioners. It provides a guide to these legal instruments and standards in an accessible way. It follows upon a multilateral meeting held in Strasbourg in spring 2015 which helped bring together management and leadership from prison services from across Europe to address issues of common concern. It was clear from the discussions during the two days of the meeting that not only do many countries face the same set of problems, but also that “good practice” does exist across Europe, and that discussion not only of these challenges but also of possible solutions can be of real assistance. Following the meeting, representatives were asked to highlight further instances of “good practice” in their countries that could be of use elsewhere across Europe. Many good ideas were highlighted. In the space available, only a handful of these could be included.Prison-based health serviceRights of drugs and alcohol usersPrisonAdvocacyDrug or health care workerSocial workerPrison Inmate (prisoner)Europe2016Council of EuropeEvidence resource

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Drugs and AlcoholGuidelines on the management of co-occurring alcohol and other drug and mental health conditions in alcohol and other drug treatment settings.ChristinaMarelauthorKatherine LMillsauthorRosemaryKingstonauthorKevinGournayauthorMarkDeadyauthorFrancesKay-LambkinauthorAmandaBakerauthorMareeTeessonauthorThese Guidelines aim to provide alcohol and other drug (AOD) workers with evidence-based information to assist with the management of co-occurring, or comorbid, AOD and mental health conditions. They represent an update and revision of the first edition of these Guidelines published in 2009. Population estimates indicate that more than one-third of individuals with an AOD use disorder have at least one comorbid mental health disorder; however, the rate is even higher among those in AOD treatment programs. Additionally, there are a large number of people who present to AOD treatment who display symptoms of disorders while not meeting criteria for a diagnosis of a disorder. The high prevalence of comorbidity means that AOD workers are frequently faced with the need to manage complex psychiatric symptoms that may interfere with their ability to treat clients’ AOD use. Furthermore, clients with comorbid mental health conditions often have a variety of other medical, family, and social problems (e.g., housing, employment, welfare, legal problems). As such, it is important that AOD workers adopt a holistic approach to the management and treatment of comorbidity that is based on treating the person, not the illness (see Chapter B1). The first step in responding to comorbidity is being able to identify the person’s needs (see Chapters B2 and B3). Despite high rates of comorbidity among clients of AOD services, it is not unusual for comorbid mental health conditions to go unnoticed. This is mostly because AOD workers are not routinely looking for them. It is a recommendation of these Guidelines that all clients of AOD treatment services should be screened and assessed for comorbidity as part of routine clinical care. Once identified, symptoms of mental health conditions may be effectively managed while the person is undergoing AOD treatment (see Chapters B5 and B6). The goal of management is to allow AOD treatment to continue without mental health symptoms disrupting the treatment process, and to retain clients in treatment who might otherwise discontinue such treatment. Comorbidity is not an insurmountable barrier to treating people with AOD use disorders. Indeed, research has shown that clients with comorbid mental health conditions can benefit just as much as those without comorbid conditions from usual AOD treatment. Some clients with comorbidity may require additional treatment for their mental health problems (see Chapter B6). Some interventions have been designed for the treatment of specific comorbidities; however, these interventions generally have not been well researched. Where there is an absence of specific research on comorbid disorders, it is recommended that best practice is to use the most effective treatments for each disorder. Both psychosocial and pharmacological interventions have been found to have some benefit in the treatment of many comorbidities. Consideration should also be given to the use of e-health interventions, physical activity, and complementary and alternative therapies, as an adjunct to traditional treatments. In addition to mental health services, AOD workers may need to engage with a range of other services to meet clients’ needs, including housing, employment, education, training, community, justice, and other support services. A broad, multifaceted, and co-ordinated approach is needed in order to address all of these issues effectively, and it is important that AOD services and workers develop links with a range of local services (see Chapter B4).Mental healthDual diagnosis (comorbidity)Drugs and alcohol related mental disorderGeneral treatment method conceptsTreatment outcomeTreatment factorsMental health careDrug or health care workerDoctorNurseSocial workerAustralia2016Australia: Centre of Research Excellence in Mental Health and Substance Use, National Drug and AlcoholEvidence resource

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Drugs and AlcoholHealth and social care professions education and development strategy 2016 – 2019.Health and Social Care Professions (HSCP) is a term used to encompass a diverse, highly educated and skilled range of professionals with significant contributions to make to the health, care, wellbeing and quality of life of the population. HSCP are well positioned and have the skills to support the goals outlined in the HSE Corporate Plan 2015 - 2017. The aim of this current HSCP Education and Development Strategy is to support achievement of the Corporate Plan and the People Strategy 2015-2018.Workforce / staff skills and trainingDrug or health care workerNurseSocial workerIreland2016Health Service ExecutiveReport

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Drugs and AlcoholScoping review of case management in the treatment of drug and alcohol misuse, 2003–2013.SaoirseNic GabhainnauthorMD'EathauthorMartinKeaneauthorJaneSixsmithauthorThis is the final report of a scoping review commissioned by the HRB National Drugs Library. The objective of the review was to examine the peer-reviewed non-experimental literature on case management and substance use published between 2003 and 2013, and to answer specific research questions based on the literature. These comprised questions on the nature of case management, the outcomes that have been studied, and gaps in the literature.Drugs and alcohol disorder treatment methodPatient care managementHealth care deliveryAOD task forcesProgramme planning, implementation, and evaluationProgramme planning (strategy)Drug or health care workerPrevention workerSocial workerInternational aspects2016Health Research BoardReport

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Drugs and AlcoholGuidance for providers of health and social care services for children. Communicating in plain English with children and their families.Communicating in plain English with children and their families; this guide will help you to communicate more clearly with children, their parents or other caregivers, and friends. It will help you to think about how you present information so that children and others will understand it the first time they read or hear it.Health information and educationInformation disseminationDrug or health care workerPrevention workerSocial workerIreland2015-11Health Information and Quality AuthorityReport

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Drugs and AlcoholAssessment, consultation and therapy service annual report 2014 and service plan 2015.ACTS is a national specialist clinical service which provides multidisciplinary consultation, assessment and focused interventions to young people who have high risk behaviours associated with complex clinical needs. ACTS also supports other professionals in their ongoing work with young people and their families. This includes: • On-site therapeutic services to young people in secure settings in Ireland (Special Care and the Children Detention Schools); • Ongoing support when young people return to community settings to help them to reengage with mainstream services, as appropriate; • Support through some of the difficult transitions in young people’s lives; • Consultation in the community for young people at significant risk of placement in secure settings. ACTS provides multidisciplinary interventions supported by evidence based research literature; clinically informed practice based evidence; best international practice and in accordance with relevant legislation, policy and guidelines. The aim of the service is to facilitate the provision of more therapeutic environments in the national Special Care Units and Children Detention Schools and to work in partnership with others to improve outcomes for the most vulnerable young people in Ireland. This document outlines the purpose and vision of this service as well as a set of core values. Together these inform the strategic focus of the service and form the basis for service development priorities for 2015.Youth (juvenile) offendingCommunity anti-crime or legal assistance programmeServices for family and childrenServices for children of drugs and alcohol usersChildAdolescent / youth (teenager / young person)Drug or health care workerSocial workerChild of drugs and alcohol userIreland2015-11TuslaReport

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Drugs and AlcoholAlcohol Matrix cell D1: Organisational functioning - Screening and brief intervention.AlcoholAlcohol dependenceMedical screening and diagnostic methodPsychosocial screening and diagnostic methodIdentification and screening for drugs and alcohol useHealth care deliveryCommunity-based treatment (primary care)Health care administrationOrganisational developmentWorkforce / staff skills and trainingDrug or health care worker2015-10Drug and Alcohol Findings and the Substance Misuse Skills ConsortiumEvidence resource

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Drugs and AlcoholEuropean Drug Prevention Quality Standards (EDPQS) toolkits to support quality in prevention.As a result of a 2-year project to develop practical tools which could support practitioners, policy-makers and other members of the prevention community to achieve quality in prevention based on the EDPQS.Policy on drugs and alcoholEducation and trainingEducation by subjectEducational environment (school / college)Drug or health care workerPrevention workerSocial workerInternational aspects2015-10Evidence resource

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Drugs and AlcoholCreating a psychologically informed environment. implementation and assessment.A Psychologically Informed Environment (PIE) “... is one that takes into account the psychological makeup – the thinking, emotions, personalities and past experience - of its participants in the way that it operates.” It’s an approach to supporting people out of homelessness, in particular those who have experienced complex trauma3 or are diagnosed with a personality disorder. It also considers the psychological needs of staff: developing skills and knowledge, increasing motivation, job satisfaction and resilience. Many of the clients homeless services work with seem to have difficulty managing their emotions, appear impulsive and do not consider the consequences of their actions. Some may be withdrawn, isolated and reluctant to engage or exhibit anti-social behaviour. The purpose of a PIE is to help staff understand where these behaviours are coming from and therefore work more creatively and constructively with challenging behaviours. A PIE has 5 key elements: 1. Relationships 2. Staff support and training 3. The physical environment and social spaces 4. A psychological framework 5. Evidence generating practiceCoping skillsAttitude and behaviourSpecific attitude and behaviourNeeds assessmentCommunity needs assessmentCommunity environmentWorkforce / staff skills and trainingDrug or health care workerNurseCounsellor / TherapistSocial workerEngland2015-10Westminster City CouncilEvidence resource

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Drugs and AlcoholCo-production in social care: what it is and how to do it.In its simplest essence, to co-produce is to make something together. Co-production is not just a word, it's not just a concept, it is a meeting of minds coming together to find shared solutions. Key messages: • Co-production is about developing more equal partnerships between people who use services, carers and professionals. • It is important to have an agreed definition between everyone taking part in any co-production activity. • There are key principles for co-production around equality, diversity, access and reciprocity. • Co-production can help make the best use of resources, deliver better outcomes for people who use services and carers, build stronger communities and develop citizenship. • To do co-production, organisations need to make changes to their culture, structure and practice and to regularly review progress.Attitude toward drugs and alcohol addict or userHealth care deliveryAdvocacyWorkforce / staff skills and trainingDrug or health care workerPrevention workerSocial workerUnited Kingdom2015-10Social Care Institute for ExcellenceEvidence resource

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Drugs and AlcoholPhysician, heal thyself.Ann-MarieHardimanauthorThe Practitioner Health Matters Programme, launching this September, aims to support and care for dentists and other health professionals who may have a substance misuse problem or mental health issue. Formerly the Sick Doctors Scheme, which supported doctors for over 25 years, the new Programme has been updated to reflect international best practice in practitioner health, and for the first time is also open to dentists and pharmacists. Dr Íde DeLargy, a GP based in Blackrock in Dublin, is Clinical Lead for the new Programme, having been involved with the Sick Doctor Scheme since 2008. She explained the particular issues that affect health practitioners. "Doctors, dentists and pharmacists are very slow to come forward to declare that they might have a problem with mental health issues and alcohol or substance issues. Therefore, what we find is that they present very late and usually in crisis.".....Drug or health care workerDoctorIreland2015-09Irish Dental AssociationArticle

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Drugs and AlcoholA practical guide to including seldom-heard children and young people in decision making.OliviaMcEvoyauthorNeeds assessmentAdvocacyAdolescent / youth (teenager / young person)Drug or health care workerPrevention workerSocial workerChild of drugs and alcohol userIreland2015-09Government PublicationsEvidence resource

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Drugs and AlcoholHealth matters: smoking and quitting in England.Public Health England (PHE) wants to see a tobacco-free generation by 2025. Despite a continuing decline in smoking rates, nearly 1 in 5 adults still smoke and there are around 90,000 regular smokers aged between 11 and 15. The following shows what we know works to help people stop smoking. Smoking and the harm it causes aren’t evenly distributed. People in more deprived areas are more likely to smoke and are less likely to quit. Smoking is increasingly concentrated in more disadvantaged groups and is the main contributor to health inequalities in England. Men and women from the most deprived groups have more than double the death rate from lung cancer compared with those from the least deprived. Smoking is twice as common in people with longstanding mental health problems. There are relatively high smoking levels among certain demographic groups, including Bangladeshi, Irish and Pakistani men and among Irish and Black Caribbean women. Smoking in pregnancy increases the risks of miscarriage, stillbirth or having a sick baby, and is a major cause of child health inequalities.Tobacco (cigarette smoking)Tobacco smoke (cigarette law / policy)Drug or health care workerPrevention workerUnited Kingdom2015-09Public Health EnglandEvidence resource

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Drugs and AlcoholCompetencies for the youth substance use prevention workforce: youth substance use competencies report.This report is the first resource of its kind to provide a set of measurable skills, knowledge, attitudes and values that support and enhance the delivery of effective youth health promotion and drug use prevention in Canada. The Prevention Workforce Competencies Report also identifies principles that should drive effective youth substance use prevention activities and initiatives. Those working in youth health promotion and substance abuse prevention face knowledge gaps, inconsistencies in recommended evidence and practice, a lack of understanding of and support for successful youth engagement, and a lack of common terminology and language. These challenges affect their ability to work effectively with youth and with the community, and what works with adults does not necessarily work with youth. Research indicates that working with youth requires a specialized focus on issues, needs, considerations and approaches. These points were carefully considered during research and validation for the report. The most effective youth substance use prevention activities and initiatives feature a holistic, integrated, respectful, flexible and strength-based approach informed by evidence about what works. Such initiatives are youth-driven and foster the development and maintenance of positive, collaborative relationships among youth and the community of those who care for and about them. The Prevention Workforce Competencies Report sets out 11 competencies that reflect the principles for working effectively with youth and provides a description of each competency. The four levels of proficiency — introductory, developing, intermediate and advanced — provided for each competency support health promotion, youth outreach and other workers, including health professionals, throughout the progression of their careers.Organisational developmentWorkforce / staff skills and trainingAdolescent / youth (teenager / young person)Drug or health care workerPrevention workerCanada2015-08Canadian Centre on Substance AbuseEvidence resource

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Drugs and AlcoholHealth A-Z. Drug misuse.The HSE provides all of Ireland's public health services, in hospitals and communities across Ireland. Use their health A-Z to learn about hundreds of medical conditions and treatments including drug misuse.Cannabis / MarijuanaHallucinogensCNS stimulantsAmphetaminesCocaineHeroinrisk-taking behaviouremergency careDrug or health care workerPrevention workerSocial workerIreland2015-08Health Service ExecutiveEvidence resource

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Drugs and AlcoholHow good is the social care sector at building an evidence base?RuthHardyauthorHealth services, drugs and alcohol researchHealth care quality controlInformation transfer from research to practiceDrug or health care workerSocial workerUnited Kingdom2015-07-07The GuardianArticle

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Drugs and AlcoholSystems change: a guide to what it is and how to do it.RobAbercrombieauthorEllenHarriesauthorRachelWhartonauthorWe have produced this guide to plug a gap in the systems change literature—providing accessible material and recommendations for action. It introduces the basic concepts, maps out the different perspectives in the systems change landscape and suggests good practice for systemic social action. It has been written as a resource for those working or supporting the social sector—namely charities and funders, but also those in the public sector or in social enterprises. In summary, this guide: • clarifies what is meant by systems and systems change • describes the main perspectives on systems change • outlines good practice for systems change • identifies what is and is not agreed upon by experts in the field • provides recommendations for charities, funders and the public sector on how to act systemically.Patient care managementHealth care deliveryCommunity developmentAdvocacyOrganisational developmentDrug or health care workerUnited Kingdom2015-06New Philanthropy CapitalEvidence resource

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Drugs and AlcoholSuicide prevention: an evidence review 2015.LucyDillonauthorCiaraGuineyauthorLouiseFarragherauthorAnneMcCarthyauthorJeanLongauthorIn this report, the HRB identifies suicide prevention interventions that have weak, moderate--‐ or good--‐quality evidence that they actually reduce suicidal behaviours such as suicidal ideation, self--‐harm, suicide attempts or deaths by suicide. The HRB also presents suggestions for adding to and strengthening the evidence base on suicide prevention.suicidal behaviour / suicideMental healthSuicide preventionMental health careDrug or health care workerPrevention workerIreland2015-06Health Research BoardEvidence resource

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Drugs and AlcoholChild and adolescent mental health services standard operating procedure.Mental health careChildAdolescent / youth (teenager / young person)NurseSocial workerIreland2015-06Health Service ExecutiveReport

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Drugs and AlcoholResearch evidence to prevent alcohol-related harm: what communities can do in Ireland.AnnHopeauthorA practical guide that supports communities to tackle alcohol-related harm has been developed by Galway Healthy Cities Alcohol Forum. It guides communities through evidence-based solutions that can be undertaken in local areas– and provides clear references so that people can know what is proven to work to improve health and social problems. The booklet – Research evidence to prevent alcohol-related harm: What communities can do in Ireland - translates the science into a format that can be easily understood starting with the policy areas with the strongest scientific evidence and providing practical community action opportunities. Dr Hope stressed that “key areas of supply, such as price, availability and marketing; and demand, such as early intervention need to be addressed to prevent and reduce alcohol problems”. The HSE recently announced a new policy on alcohol-related education and communications programmes, which formally separates HSE public health advice from partnership with the alcohol industry, a decision which was supported by the evidence provided in this new guide. Cate Hartigan concluded: ‘The overall approach to alcohol action across the health and community sector is informed by our collective responsibility to protect health, and to promote evidence-based alcohol policy. This new guide is an excellent example of how we can work together to reduce alcohol-related harm, and support a population to be more informed on how alcohol affects our health and wellbeing, our work and relationships, our children and our society’.AlcoholAlcohol dependenceHealth services, drugs and alcohol researchDrugs and alcohol use harm reductionCommunity-based preventionSocial supportCommunity developmentHarm reduction policyInformation transfer from research to practiceDrug or health care workerNursePrevention workerSocial workerGalway2015-06Galway Healthy Cities: Galway City Alcohol Strategy to Prevent and Reduce Alcohol-Related Harm (2013-2017).Report

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Drugs and AlcoholEvaluation of the contribution of the child protection public health nurse to inter-professional working in child protection. An integrated health and social care model of child protection.PatriciaO'DwyerauthorSheilaCahalaneauthorSusannePelican-KellyauthorPublic healthHealth care deliveryCommunity-based treatment (primary care)Workforce / staff skills and trainingSocial servicesChildAdolescent / youth (teenager / young person)NurseSocial workerCork2015-06Child and Family Agency South Lee CorkReport

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Drugs and AlcoholThe effects of drugs.Drugs and alcohol effects and consequencesCannabis / MarijuanaAmphetaminesEcstasyMephedroneCocaineDrug or health care workerNursePrevention workerSocial worker2015-05NHS ChoicesEvidence resource

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Drugs and AlcoholHealth service performance report January 2015.Opioids (opiates)Drugs and alcohol replacement method (substitution)Methadone maintenanceHealth care deliveryHealth care quality controlDrug or health care workerIreland2015-04Health Service ExecutiveReport

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Drugs and AlcoholAn adult social care compendium of approaches and tools for organisational change.RobinMillerauthorTimFreemanauthorDeborahDavidsonauthorJonGlasbyauthorThe purpose of this compendium is to support managers working in adult social care to be more knowledgeable about and confident in the application of different approaches and tools relevant to managing change in their organisations. In the compendium an ‘approach to change’ is used to denote an ‘overarching framework that can guide a change process’ and ‘change management tools’ as ‘techniques or templates to understand or support a specific aspect of the change process’. Examples of the latter would be stakeholder mapping exercises, organisational diagnostic methodologies, engagement processes, and direct team based interventions. The compendium does not provide detailed guidance on how to apply each approach and tool, but presents an accessible overview of what each entails, the thinking that lies behind them, and (where available) a reflection on the empirical evidence of their application in practice. Having access to this information will help to demystify the often confusing and intimidating terminology that surrounds change approaches, and in doing so will enable managers to identify the approaches most relevant to a change they are leading and explore in more depth. Understanding the method being followed will also support individuals who access services and their families to engage on a more equal playing field within a change process. This includes people who access services and their families. While potentially relevant to social care managers working at all levels of an organisation, the compendium is specifically designed for those responsible for a single service (e.g. home care team, residential care home) or team (e.g. care management team), and those who directly manage service and team managers. Section 1: Fictional case studies which illustrate how four key approaches to could be deployed within adult social care. These case studies also illustrate how other change management tools could be incorporated within such a change process. Further details and supporting resources for each approach and tool are provided in Section 2. Section 2: A directory of change approaches and change management tools based on a review of current literature including available empirical research and the views of people who have experienced and led change. A short commentary on the application of the social care change principles through these approaches is also provided.Health care deliveryHealth care quality controlSocial supportOrganisational developmentSocial servicesDrug or health care workerSocial workerUnited Kingdom2015-04Social Care Institute for ExcellenceEvidence resource

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Drugs and AlcoholPeer support toolkit.There is a strong tradition of peer support in the drug and alcohol field. The people involved go by various names – recovery champions, buddies, peer mentors and more – but the gist remains the same: that people themselves in recovery from drug and alcohol use can be authentic and effective voices in supporting others along their own journeys. This toolkit brings together information for peer supporters and their managers.Peer relationsSocial supportAdolescent / youth (teenager / young person)Drug or health care workerPrevention workerUnited Kingdom2015-01Substance Misuse Skills ConsortiumEvidence resource

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Drugs and AlcoholStep by step toolkit. Preparing for work with children and young people who inject drugs.Globally, the protection and care of children and young people who inject drugs receives little attention. It is a controversial and often misunderstood issue and one that is severely underfunded. Global research presents shocking figures and evidence of restrictive laws preventing young people from accessing harm reduction. Rarely are services developed with children under 18 in mind, and organisations often lack capacity to attend to this highly vulnerable group. Young people also report experiencing significant barriers to accessing harm reduction services when they are under 18 due to a number of factors, including staff attitudes and organisational policies and practices. This tool is a product of a partnership between Harm Reduction International (HRI), Youth Rise, International HIV/AIDS Alliance and Save the Children and was developed in response to HRI research on injecting drug use among under 18s globally that highlighted gaps in the response for this group. This resource is intended for harm reduction service providers with limited experience of working with children and young people who inject drugs. It sets out a process that you can go through quickly, with little cost, to prepare for work with children and young people who are under 18. It is designed to help your organisation and staff to feel safe in commencing this work, and to support you in thinking through the challenging situations and decisions that you face. In some cases, it may lead you to decide that you are not yet ready to go ahead with this work.Drugs and alcohol use harm reductionCommunity-based preventionOrganisational developmentWorkforce / staff skills and trainingChildAdolescent / youth (teenager / young person)Intravenous / injecting drug userDrug or health care workerPrevention workerSocial workerUnited Kingdom2015International HIV/AIDS AllianceEvidence resource

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Drugs and AlcoholHelp me understand.JoannaManningauthorCarolineHorstauthorParent-child relationsDrug or health care workerPrevention workerSocial workerChild of drugs and alcohol userUnited Kingdom2015The Children's SocietyEvidence resource

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Drugs and AlcoholAlcohol-related brain injury a guide for professionals.HelenMcMonagleauthorMarkHoganauthorAnne MarieMorrisseyauthorFionaMillsauthorCarolineMcMonagleauthorSineadTolanauthorSeanO DomhnaillauthorMaryButlerauthorOur over-arching aim of this guide is to improve the overall quality of care individuals with Alcohol- Related Brain Injury (ARBI) receive during their contact with services. By encouraging a chain of intra and inter-professional dialogue around ARBI we hope to cultivate a multi-disciplinary cross-tier approach to the identification, assessment, treatment and rehabilitation of this disorder.Drugs and alcohol effects and consequencesAlcoholPhysical healthDrugs and alcohol related disorderHealth care deliveryDrug or health care workerDoctorNurseSocial workerIreland2015Alcohol forumReport

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Drugs and AlcoholMeitheal toolkit.The Meitheal Toolkit is intended for use by practitioners using Meitheal – A National Practice Model for all agencies working with children, young people and their families. It provides direction, guidance and advice on all stages of the Meitheal process and as such can be used as a roadmap for undertaking a Meitheal effectively. The toolkit is a practical resource that will: • inform and guide practitioners through the Meitheal process; • provide direction, advice and guidance on how best to undertake the Meitheal process; • provide support and guidance to Lead Practitioners to undertake their role effectively in the Meitheal process; • identify how to store and share information safely as part of the Meitheal process; • provide Meitheal documentation and guidance on how to complete Meitheal Forms; • provide guidance on facilitating meetings as part of the Meitheal process. The Meitheal Toolkit has been developed as a resource that practitioners can use either in its entirety to get an overall understanding of the Meitheal process and how it works in practice, or that practitioners can dip in and out of in accordance with the stage of the Meitheal process they are currently working on. The list of Contents is a useful tool to aid your navigation through the toolkit. The toolkit is also designed in order to be located online on the Tusla website (www.tusla.ie). For this reason, when you are reading it in the form of one complete document, you may find some repetition.Family supportServices for family and childrenDrug or health care workerSocial workerIreland2015TuslaReport

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Drugs and AlcoholSubstance use and sight loss: a guide for professionalsSarahGalvaniauthorWulfLivingstonauthorHannahMorganauthorSarahWaddauthorThis was an exploratory study of the relationship between substance use – alcohol and other drugs – and sight loss. Its origins lay in practice-based concerns about the extent to which service provision met the needs of people with sight loss who were experiencing problematic substance use. A preliminary review of the international literature found limited evidence relating to medical or clinical associations between sight loss and substance use but almost no literature that explored the experiences of those living, or working with, sight loss and substance use. Therefore, this study sought to answer three key research questions: • What does current evidence reveal about the nature and extent of the relationship between substance use and sight loss? • What is the role substance use plays in the lives of people with sight loss? • What are the experiences of professionals working with people who have sight loss and substance problems? Key findings: • People with sight loss are more likely than their sighted peers to abstain from drinking alcohol. Analysis of two UK datasets showed that they are also more likely to drink fewer units of alcohol per week. • An international review of the literature found very little evidence for substance use leading directly to sight loss. • There was evidence that substance use may be a risk for sight loss conditions such as ‘tobacco-alcohol amblyopia’ or ‘toxic amblyopia’ where heavy substance use is combined with other risk factors including smoking or poor nutrition. • Among the people we spoke to who were living with sight loss and current or past substance use, some had been told by sight loss professionals that their alcohol or other drug use caused their sight loss. • For some people their substance use was a way of coping with the negative experiences of sight loss. • Among the professionals we spoke to, the number of people they worked with who had sight loss and substance problems was small but those who did posed considerable professional challenges. • In general, professionals in sight loss and substance use services felt they were not adequately equipped with the knowledge, professional guidance or organisational policy frameworks, to help them to identify and respond confidently when working with someone with both sight loss and substance problems. • Professionals identified partnership working as key to providing support and to stopping people falling through the gap in services. Joint training and resources for staff and individuals are recommended.Prevalence of drugs and alcohol useAlcohol consumptionAlcoholCoping skillsPhysical healthMental healthSocial supportWorkforce / staff skills and trainingDrug or health care workerDoctorNurseSocial workerUnited Kingdom2014-12Alcohol research UKEvidence resource

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Drugs and AlcoholDrug matrix cell B5: Practitioners - safeguarding the community.Drugs and alcohol related societal (social) problemsAttitude toward drugs and alcohol addict or userPatient attitude toward treatmentProvider attitude toward treatmentCommunity environmentSocial costs and benefits of drugs and alcoholWorkforce / staff skills and trainingDrug or health care workerDoctorNurseCounsellor / TherapistSocial worker2014-11Drug and Alcohol FindingsEvidence resource

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Drugs and AlcoholDrug matrix cell C5: Management/supervision - safeguarding the community.Attitude toward drugs and alcohol addict or userPatient attitude toward treatmentProvider attitude toward treatmentCommunity environmentOrganisational developmentWorkforce / staff skills and trainingDrug or health care workerNurseCounsellor / TherapistSocial worker2014-11Drug and Alcohol Findings and the Substance Misuse Skills ConsortiumEvidence resource

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Drugs and AlcoholDrug matrix cell D5: Organisational functioning - safeguarding the community.Treatment and maintenanceHealth care programme or facilityDrugs and alcohol disorder treatment unitOrganisational developmentWorkforce / staff skills and trainingDrug or health care workerNurseSocial worker2014-11Drug and Alcohol Findings and the Substance Misuse Skills ConsortiumEvidence resource

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Drugs and AlcoholHealth service national service plan 2015.Tobacco smoke (cigarette law / policy)Public healthMethadone maintenanceTreatment factorsHealth care deliveryHealth care quality controlHealth care economicsHarm reduction policyDrug or health care workerIreland2014-11Health Service ExecutiveReport

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Drugs and AlcoholSupporting children in families experiencing mental health difficulties.MargaretCurtinauthorMental health careFamily supportFamily roleChildSocial workerChild of drugs and alcohol userIreland2014-10Health Research BoardArticle

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Drugs and AlcoholDrug Matrix cell B4: Practitioners - psychosocial therapies.Psychosocial treatment methodBehaviour therapyGroup therapyTreatment outcomePsychoanalytic therapyTreatment factorsPatient attitude toward treatmentProvider attitude toward treatmentDrug or health care workerCounsellor / Therapist2014-10Drug and Alcohol Findings and the Substance Misuse Skills ConsortiumEvidence resource

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Drugs and AlcoholDrug Matrix cell C4: Management/supervision - psychosocial therapies.Psychosocial treatment methodTreatment outcomeTreatment factorsHealth care deliveryHealth care quality controlOrganisational developmentWorkforce / staff skills and trainingDrug or health care workerCounsellor / Therapist2014-10Drug and Alcohol Findings and the Substance Misuse Skills ConsortiumEvidence resource

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Drugs and AlcoholDrug Matrix cell D4: Organisational functioning - psychosocial therapies.Psychosocial treatment methodHealth care deliveryHealth care administrationOrganisational developmentWorkforce / staff skills and trainingDrug or health care worker2014-10Drug and Alcohol Findings and the Substance Misuse Skills ConsortiumEvidence resource

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Drugs and AlcoholDrug Matrix cell E3: Treatment systems - medical treatment.Drugs and alcohol disorder treatment methodTreatment outcomeTreatment factorsHealth care deliveryHealth care administrationHealth care quality controlOrganisational developmentWorkforce / staff skills and trainingInformation transfer from research to practiceDrug or health care worker2014-09Drug and Alcohol Findings and the Substance Misuse Skills ConsortiumEvidence resource

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Drugs and AlcoholOpen your eyes. HSE elder abuse services 2013.P.55 - Issues and Interventions for the Person Causing Concern In 2013 there were 440 alleged perpetrators that were listed by the Senior Case Worker as having at least one possible health issue reported. A summary of health issues is presented in figure 17 (p.55)- alcohol and mental health issues predominate. “Other issues” continue to be internal family issues and carer stress. (Drugs 6% and alcohol 28%). P.58 - Self neglect Currently, there are 191 cases open - representing 36% of all self neglect cases with results on a par with 2012. The provision of services and supports to individuals that are neglecting themselves, does not involve legal or Garda involvement to the same extent as elder abuse cases more generally. Garda consultation occurred in 4%, Garda notification in 9% and legal action in 3% of cases. In total, 62% of clients availed of a service, a further 27% declined the service offered while the balance 11% were not offered any service. Home support and monitoring were the dominant services offered. Of particular significance to the older person is the fact that, when looking at overall service provision, the provision of residential care has increased from 8% in 2012 to 12% in 2013. “Other services” related to addiction and cleaning services. Within this group 161 clients had a documented health issue - these related to physical, mental health, dementia and alcohol(p.59). In comparison to cases of elder abuse the impact of alcohol issues is highly significant in self neglect (18% Vs 5%). (Drugs 1% alcohol 18%)Prevalence of drugs and alcohol useHealth care deliveryHealth care quality controlSocial servicesElderly / Older personSocial workerIreland2014-09Health Service ExecutiveReport

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Drugs and AlcoholDrug Matrix cell A3: Interventions - medical treatment.BuprenorphineGeneral treatment method conceptsDrugs and alcohol disorder treatment methodDrugs and alcohol replacement method (substitution)Methadone maintenanceTreatment outcomePatient care managementTreatment factorsDrug or health care workerDoctor2014-08Drug and Alcohol Findings and the Substance Misuse Skills ConsortiumEvidence resource

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Drugs and AlcoholDrug Matrix cell B3: Practitioners - medical treatment.Treatment outcomeTreatment factorsProvider attitude toward treatmentCommunity-based treatment (primary care)Workforce / staff skills and trainingDrug or health care workerDoctorNurseCounsellor / Therapist2014-08Drug and Alcohol Findings and the Substance Misuse Skills ConsortiumEvidence resource

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Drugs and AlcoholDrug Matrix cell C3: Management/supervision - medical treatment.Drugs and alcohol replacement method (substitution)Methadone maintenanceHealth care deliveryHealth care quality controlOrganisational developmentWorkforce / staff skills and trainingDrug or health care workerDoctor2014-08Drug and Alcohol Findings and the Substance Misuse Skills ConsortiumEvidence resource

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Drugs and AlcoholDrug Matrix cell D2: organisational functioning - generic and cross-cutting issues.Treatment factorsHealth care deliveryHealth care administrationHealth care quality controlOrganisational developmentWorkforce / staff skills and trainingDrug or health care worker2014-08Drug and Alcohol Findings and the Substance Misuse Skills ConsortiumEvidence resource

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Drugs and AlcoholDrug Matrix cell E2: Treatment systems - Generic and cross-cutting issues.Drugs and alcohol recoveryGeneral treatment method conceptsTreatment outcomeTreatment factorsRehabilitationHealth care deliveryHealth care administrationHealth care quality controlOrganisational developmentWorkforce / staff skills and trainingDrug or health care worker2014-08Drug and Alcohol Findings and the Substance Misuse Skills ConsortiumEvidence resource

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Drugs and AlcoholThe quality principles: standard expectations of care and support in drug and alcohol services.The Quality Principles are central to the implementation of the Scottish Government’s Quality Improvement Framework for drug and alcohol treatment and support services. The Quality Improvement Framework is made up of: • a set of Quality Principles supported by the Recovery Philosophy – developed in collaboration with current service users, those in longer-term recovery and staff working within services; • revised planning and reporting arrangements for Alcohol and Drug Partnerships (ADPs); • a programme of development for the drug and alcohol workforce – that is anyone who has a role in improving outcomes for individuals, families or communities affected by problematic drug and alcohol use; • the development of a single integrated data collection system for drugs and alcohol (DAISy); and • support and guidance for ADPs – including commissioning guidance, supported self-evaluation and the Quality Principles Toolkit. The Quality Improvement Framework should support and drive a culture of self-assessment whereby services are commissioned based on evidence of meeting these principles of care, which will be measured by a range of tools including an agreed set of quality indicators of recovery, and are open to being supported to make improvements to the quality of the service.Drugs and alcohol recoveryProvider attitude toward treatmentHealth care deliveryHealth care quality controlPolicy on drugs and alcoholOrganisational developmentWorkforce / staff skills and trainingDrug or health care workerScotland2014-08Scottish GovernmentEvidence resource

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Drugs and AlcoholDrug Matrix cell B2: practitioners: generic and cross-cutting issues.Treatment factorsPatient attitude toward treatmentProvider attitude toward treatmentWorkforce / staff skills and trainingDrug or health care workerCounsellor / TherapistSocial worker2014-07Drug and Alcohol Findings and the Substance Misuse Skills ConsortiumEvidence resource

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Drugs and AlcoholDrug Matrix cell C2: management/supervision - generic and cross-cutting issues.Treatment factorsHealth care deliveryHealth care administrationOrganisational developmentWorkforce / staff skills and trainingInformation transfer from research to practiceDrug or health care worker2014-07Drug and Alcohol Findings and the Substance Misuse Skills ConsortiumEvidence resource

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Drugs and AlcoholNon-medical prescribing in the management of substance misuse.Non-medical prescribing (NMP) – namely, the prescribing of medicines by health professionals who are not doctors – allows for increased availability and responsiveness of prescribing interventions. The non-medical management of substance misuse in the UK was revolutionised by 2012’s change to allow non-media prescribers to independently prescribe for the treatment of drug dependence. PHE’s new document is intended for non-medical prescribers and all those with an interest in NMP including aspiring non-medical prescribers, consultants and clinical leads, service managers, NMP leads, colleagues from different professions (eg, doctors, psychologists, and social workers) and service commissioners. Non-medical prescribing in the management of substance misuse was prepared by an expert group convened by PHE alcohol, drugs and tobacco and the National Substance Misuse Non-Medical Prescribing Forum (NSMNMPF). The document defines clear parameters within which non-medical prescribing can be delivered safely and effectively within recovery-orientated drug and alcohol treatment systems.Drugs and alcohol disorder treatment methodDrugs and alcohol disorder drug therapyPatient care managementHealth care deliveryDrug or health care workerUnited Kingdom2014-07Public Health EnglandEvidence resource

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Drugs and Alcohol‘Legal highs’ and novel psychoactive substances. Alcohol and drug prevention briefing paper.New (novel) psychoactive substancesPrevention through information and educationHealth information and educationLegal availability or accessibilityAOD educationPrevention workerUnited Kingdom2014-06Mentor ADEPSISEvidence resource

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Drugs and AlcoholEfficient needs assessment in schools.Needs assessmentDrugs and alcohol preventionSchool-based preventionSchool contextSchool drugs and alcohol policyStudent (secondary level)Student (primary level)Drug or health care workerPrevention workerSocial workerUnited Kingdom2014-03Mentor ADEPSISEvidence resource

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Drugs and AlcoholSteps towards effective teamworking in community mental health teams.CTwomeyauthorMByrneauthorTLeahyauthorDrug or health care workerDrugs and alcohol recoveryMental health careIrelandPatient care managementHealth care deliveryWorkforce / staff skills and training2014-03Medmedia GroupArticle

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Drugs and AlcoholSupporting pregnant women who use alcohol or other drugs - a guide for primary health care professionals.PregnancyDevelopmental disorderFoetal (fetal) alcohol syndromeParental supportPregnant womanDrug or health care workerNurseSocial workerChild of drugs and alcohol userAustralia2014National Drug and Alcohol Research CentreEvidence resource

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Drugs and AlcoholDrug misuse overview.Cannabis / MarijuanaCNS stimulantsOpioids (opiates)Drugs and alcohol disorder treatment methodDrugs and alcohol disorder drug therapyMethadone maintenanceDetoxification methodPsychosocial treatment methodIdentification and screening for drugs and alcohol usePatient care managementFamily supportDrug or health care workerNursePrevention workerSocial worker2014National Institute for Health and Care ExcellenceEvidence resource

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Drugs and AlcoholA framework for personalised care and population health for nurses, midwives, health visitors and allied health professionals.This framework has been developed to underpin the UK national programme to maximise nurses, midwives, health visitors (HVs) and allied health professionals (AHPs) impact on improving health outcomes and reducing inequalities. The framework supports and shapes health promoting practice and embeds personalised care and population health across all ages, care places and with individuals, families and communities. It is a resource to support practitioners’ access to best evidence for practice and to support nurse managers and commissioners to develop services which use the knowledge and skills that nurses, midwives, HVs and AHPs use to deliver the best health outcomes for the populations they serve. There are six key areas of population health activity in the framework. In each population health activity area are one or more worked examples on national health priority areas that illustrate how the framework should be used. • Wider determinants of health • Health improvement • Health protection • Healthcare public health • Health, wellbeing & independence • Lifecourse [Alcohol section on page 32-36; also contains references to smoking throughout the document]AlcoholPregnancyPublic healthHealth promotionPatient care managementHealth care deliveryDrug or health care workerNurseSocial workerUnited Kingdom2014Department of HealthEvidence resource

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Drugs and AlcoholIdentifying and supporting children affected by parental substance misuse – Resource for schools.How can schools identify and support pupils affected by parental substance misuse? This resource has been developed for the Alcohol and Drug Education and Prevention Information Service (ADEPIS) by Adfam, the national umbrella organisation for those working with and for families affected by drugs and alcohol, and is intended to be a useful tool to help schools in safeguarding their pupils. The purpose of this resource: When schools and teachers think about ‘drugs’, they may often initially focus on incidents on school grounds and how to respond to them, students at risk of using substances, or perhaps about drug education. However, substance use can impact the lives of young people in many ways, especially if they are affected by problematic drug or alcohol use in their own homes. This resource aims to summarise the key issues for children affected by parental substance use, and how schools can consider supporting them. It is aimed primarily at school governors and headteachers, but will also be relevant to members of staff with particular pastoral care duties, including school nurses, Education Welfare Officers, and anyone identified as a Designated Senior Person (DSP) for child protection in schools. Key messages: • Parental substance use is not a problem that schools can ‘solve’ alone, nor is it an issue they should turn a blind eye to • Schools have both the responsibility and the ability to support children affected by parental substance use • Safeguarding is a matter of child welfare, not drug and alcohol expertise • Existing structures/policies cover most of this work already, but added focus is neededSocial supportFamily supportParent-child relationsSchool contextSchool drugs and alcohol policyAdolescent / youth (teenager / young person)Student (secondary level)Student (primary level)Drug or health care workerPrevention workerSocial workerChild of drugs and alcohol userUnited Kingdom2013-11Mentor ADEPSISEvidence resource

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Drugs and AlcoholAddiction overview.risk-taking behaviourDrugs and alcohol disorderDrug dependencerisk factorsTreatment factorsDrug or health care workerNurseSocial worker2013-10NHS ChoicesEvidence resource

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Drugs and AlcoholSomeone to care: the mental health needs of children and young people in the care and youth justice system.RosaleenMcElvaneyauthorMimiTatlow-GoldenauthorRoisinWebbauthorEilisLawlorauthorBrianMerrimanauthorThis report hears from eight young adults who have been through the care system and yet show remarkable resilience. They are taking steps to move forward in their lives and have a valuable contribution to make. If we can put in place the right mental health supports for children in the care and youth justice system, we will be building better futures not just for them, but for society as a whole. We will have worked to use our new understanding of their needs to build a transformed future. The lives of our children, all of our children, will ultimately be the better for that. This report marks what the Coalition hopes will be the beginning of a process. It clearly identifies the need for a coherent and comprehensive national strategy addressing the mental health needs of young people in care and in the youth justice system. The mental health needs of these children and young people should, crucially, be central to any new policy and service developments which are currently underway in the reform of children’s services. At the heart of this process must be the young people themselves. As experts by experience, they must be involved in the planning, development and delivery of the system. Amnesty International Ireland’s 2011 polling revealed a high level of confidence in children’s ability to make decisions for themselves and in their trustworthiness. Nearly all respondents (86%) agreed it was important children have their opinions taken into account in significant decisions that affect them, while 67% agreed that children are trustworthy when voicing their opinions on decisions that will affect them. We must start listening.Mental healthRole of childYouth (juvenile) offendingAdolescent / youth (teenager / young person)Social servicesMental health careSocial supportIrelandServices for children of drugs and alcohol usersSocial workerChild2013-07Children's Mental Health CoalitionReport

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Drugs and AlcoholAlcohol misuse overview.Alcohol consumptionAlcoholrisk-taking behaviourAlcohol dependencerisk factorsDrug or health care workerNurseSocial worker2013NHS ChoicesEvidence resource

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Drugs and AlcoholNon-specialist health worker interventions for the care of mental, neurological and substance-abuse disorders in low- and middle-income countries.Nadjavan GinnekenauthorPrathapTharyanauthorSimonLewinauthorGirish NRaoauthorSMMeeraauthorJessicaPlanauthorSudhaChandrashekarauthorVikramPatelauthorBackground: In developing countries, most people with mental, neurological and substance-abuse (MNS) disorders do not receive adequate care mainly because of a lack of mental health professionals. Non-specialist health workers, but also other professionals with health roles, such as teachers, may therefore have an important role to play in delivering MNS health care. Researchers in The Cochrane Collaboration carried out a review of the effects of using non-specialist health workers or other professionals with health roles to help people with MNS disorders in developing countries. After searching for all relevant studies in scientific databases, they found 38 studies published before October 2012. Their findings are summarised below. What is a non-specialist health worker? Any type of health worker (like a doctor, nurse or lay health worker) who is not a specialist in mental health or neurology but who may have had some training in these fields. We also looked at teachers, as they can be particularly important in the care of children and youths. What the research says: The studies in this review were from 22 developing countries. In most studies, lay health workers delivered the mental health care, and addressed depression or anxiety (or both), or post-traumatic stress disorder. The review shows that the use of non-specialist health workers, compared with usual healthcare services: · may increase the number of adults who recover from depression or anxiety (or both) two to six months after treatment; · may slightly reduce symptoms formothers with depression; · may slightly reduce the symptoms of adults with post-traumatic stress disorder (non-specialists and teachers were used in one study); · probably slightly improves the symptoms of people with dementia; · probably improves/slightly improves the mental well-being, burden and distress of carers of people with dementia; · may decrease the quantity of alcohol consumed by problem drinkers. It is uncertain whether lay health workers or teachers reducepost-traumatic stress disorder symptoms among children. There were too few studies to draw any conclusions about the cost-effectiveness of using non-specialist health workers or teachers, or about their impact on people with other MNS conditions such as epilepsy, schizophrenia, and alcohol and drug abuse problems. In addition, very few studies measured unintended consequences of non-specialist health worker-led care - such effects could impact on the appropriateness and quality of care. Quality of the evidence: Overall, non-specialist health workers and teachers have some promising benefits in improving people's outcomes for general and perinatal depression, post-traumatic stress disorder and alcohol-use disorders, and patient and carer outcomes for dementia. However, this evidence is of low or very low quality in some areas, and for some issues no evidence is available. Therefore, we cannot make conclusions about which specific interventions using non-specialist health workers to help people with MNS disorders are more effective.Drug or health care workerMental health careInternational aspectsDrugs and alcohol related mental disorder2013John Wiley & Sons, LtdEvidence resource

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Drugs and AlcoholMental health & substance use. Essential information for social workers.This guide seeks to support Social Workers in their practice with people who use substances and who experience mental distress. It will also be relevant for other social and health care professionals. The information in the guide should be supplemented by further reading and learning. Contents: 3 Policy framework 5 Links between mental health & substance use 6 Impact on mental health 8 Cannabis & mental health 9 Medication & mental health 10 Assessment 12 Risk assessment 13 Intervention 14 Partnership practice 15 Resources 16 Local contact informationMental healthMental health careSocial servicesSocial workerCannabis / MarijuanaDrugs and alcohol related mental disorderUnited KingdomDrugs and alcohol in generalDrugs and alcohol effects and consequences2012-12British Association of Social WorkersEvidence resource

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Drugs and AlcoholWhat you should know about data quality. A guide for health and social care staff.The scope of this document is to provide a broad overview of data quality issues around personal health information in the Irish health and social care setting. This document is aimed at all health and social care staff members, and is a first step in raising awareness of the importance of data quality as part of the process of providing safe and effective services. Contents: • What is data quality? 6 • Who uses the data you collect? 7 • How do you benefit from data quality? 10 • What are the factors determining data quality? 11 • How is the data you collect used for decision-making? 19 • What can your organisation do to make data quality a success? 22 • What can you do to make data quality a success? 26 • What are the relevant legal requirements? 27 • How can you assess data quality? 28 • Key points 30Drug or health care workerIrelandHealth information and educationHealth care quality controlData collection methodInformation use and impact2012-11Health Information and Quality AuthorityReport

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Drugs and AlcoholEffective supervision in social work and social care.JohnCarpenterauthorCarolineWebbauthorLisaBostockauthorCarolineCoomberauthorKey messages •Research has demonstrated that good supervision is associated with job satisfaction, commitment to the organisation and retention. • Supervision appears to help reduce staff turnover and is significantly linked to employees’ perceptions of the support they receive from the organisation. • Good supervision is correlated with perceived worker effectiveness. There is some evidence that group supervision can increase critical thinking. • Supervision works best when it pays attention to task assistance, social and emotional support and that workers have a positive relationship with supervisors. • The emotionally charged nature of the work can place particular demands on people in the field. It is important to provide opportunities for reflective supervision. • In an inter-professional context, workers relate job satisfaction and professional development to their supervisor’s expert knowledge, regardless of whether respondents shared the same professional background. • The impact of supervision on outcomes for service users and carers has rarely been investigated. Anecdotal evidence suggests that supervision may promote empowerment, fewer complaints and more positive feedback. • Overall, the empirical basis for supervision in social work and social care in the UK is weak. Most of the evidence is correlational and derives from child welfare services in the USHealth care administrationSocial servicesSocial supportUnited KingdomSocial workerWorkforce / staff skills and training2012-10Social Care Institute for ExcellenceEvidence resource

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Drugs and AlcoholEffectiveness Bank Bulletin [Training to reduce burn-out amongst staff]Whole team training to reduce burn-out amongst staff on an in-patient alcohol ward. Hill R.G., Atnas C.I., Ryan P. et al. Journal of Substance Use: 2010, 15(1), p. 42–50. Even more so than in a typical psychiatric ward, staff at a London inpatient alcohol treatment ward experienced high levels of stress and other indicators of the potential for 'burn-out'. Whole-team training seemed to help, reflected especially in feelings of greater competence in working with sometimes challenging and complex patients. Summary: Occupational stress and burn-out are common among hospital and community-based mental health staff; staff working where aggression and violence occur are at particular risk. The Maslach Burn-out Inventory is a questionnaire often used to measure these variables. It assesses feelings of emotional exhaustion, depersonalisation, and personal accomplishment. The results confirm high levels of stress and strain among mental health professionals, yet very little empirical work has been undertaken on ways to counter this, and the few studies there are generally had a weak research design. The featured report derives from the EU-funded OSCAR project (Occupational Stress with Mental Health Clients in Acute Response). In five European countries, this aimed to gather information on occupational stress and burn-out among mental health workers in acute psychiatric hospital and community settings, investigate the causes, and test ways to reduce the problem. The strategy was to work with whole staff teams in order to affect team culture and introduce and 'bed down' working practices aimed at stress reduction. In Britain the project was implemented at a mixed-sex, 16-bed inpatient ward in south east England offering generally a 28-day programme including group and individual therapy and detoxification for adults dependent on alcohol. It averaged five admissions a week. The ward had 19 staff; three quarters were women and two thirds had worked on the ward for under three years. Only one recalled in-service training on dealing with stress. These staff completed the Maslach Burn-out Inventory. Three months later, as a team they underwent a two-day stress-reduction training course, the impacts of which were assessed by repeating the inventory a month later. The two days of the training were separated by a fortnight. Day one focused on managing stress at the individual, team and organisational levels. Day two focused on understanding the causes and consequences of aggression, involving identifying typical antecedents of violence from a comprehensive perspective, including client-related, environmental, team, and organisational factors. The team was then helped to undertake a comprehensive risk assessment along with plans for implementing effective risk management strategies.Drug or health care workerLabour and workEnglandCoping skillsWorkforce / staff skills and training2012-08-09Drug and Alcohol FindingsEvidence resource

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Drugs and AlcoholReport of the Independent Child Death Review Group 2000-2010.GeoffreyShannonauthorNorahGibbonsauthorThe report, authored by Dr. Geoffrey Shannon and Norah Gibbons, gives details of the 196 children who died over the period 2000-10, both of natural and unnatural causes. The children in the report include children who were in the care of the state at the time of their death, young adults who were in aftercare and other children who were not in care but were known to the HSE. Speaking at the publication of the report, Minister Fitzgerald said; “Before this Government took office; there was conflicting data about the numbers of children who died in state care. The lack of transparency and the lack of accountability, shocked. It was utterly unacceptable that the state could not even tell how many children had died in state care. The Minister stated that this report now gives clarity on this vital issue. There were 112 children who died of unnatural causes; 17 of whom were in care, 27 of whom were in receipt of aftercare and 68 of whom were not in care, but were in some way known to the HSE child and family services. The children and young adults in this report died from a range of causes. Some died from a range of illnesses, 4 died of accidental drowning; 5 died in house fires; 17 died from road traffic accidents; 16 were unlawfully killed; and at least 28 died by suicide. The Minister stated: “I wish to extend my deepest sympathy, and that of the state, to all those touched by a loss in this report. No parent should expect to lose a child. I do not expect today’s report to bring closure. Indeed, I am sure it will, for many, bring fresh pain. But this work shines a light on a dark, often unexamined and tragic corner of Irish life. The authors have done a professional and painstaking job in making real and understandable the lives and deaths of children who are no longer with us.” Responding to the report the Minister stated: “The findings of this report are deeply disturbing. We read of children and young people and families, often vulnerable, often in crisis, who needed support. We read of services often willing, but fragmented and not comprehensive in their response. The question must arise how, after a period of such unprecedented economic prosperity, we were left with a child protection service in need of such reform. “If ever evidence was required of the scale of the challenge which this Government and I have had to face into, then this report is it. If ever evidence was required of why we need an utterly reformed system of state care and intervention, then this report is it. And if ever evidence was required of the need to take child protection away from the HSE, wherein up until recently, it was lost, and to set up a new agency; the Child and Family Support Agency, then this report is it. The report highlighted system failings in the Irish child protections services including • Poor risk assessment • Poor co-ordination between services • Poor flows of information • Limited access to specialist assessment and therapeutic services • Limited interagency work for children and families with complex needs. • A lack of early intervention and family support services responding proportionately to the needs of children at risk and families in crisis. Commenting on these failings Minister Fitzgerald stated: “if the system had done a better job, outcomes for some of these children might well have been very different. The key to a successful child protection service is early intervention. This concept must become part of our national psyche. Parachuting in a service at a late stage is not the most efficient or effective way to help the child, or to help the family. Responding to the report Minister Fitzgerald stated that “the current government reform programme is an essential response to this report, in particular the establishment of the Child and Family Support Agency led by CEO Designate Gordon Jeyes. Already, under Gordon’s leadership we are seeing implementation of a ‘change agenda’ in children and families services which will continue and be accelerated under the new agency; and will be further informed by the recommendations of this report. Key element of the ‘change agenda’ in children and families services include: • A service delivery model that will address a multi-agency, albeit differentiated, approach to managing the child welfare and protection system; • A nationwide consistency of approach in practice and implementation of Children First and child welfare and protection services generally; • Use of standardised definitions, criteria and thresholds for reporting and referrals including prioritisation of cases; • Greater reliance on real-time data on social work referrals and alternative care collated through HSE performance management indicators and the ongoing development of the National Child Care Information System; • Improved resource allocation responsive to changing needs; • Clearer management and budgetary accountability; • Better workforce planning, training and induction of new staff.” The Minister added: “The Task Force which I established in September 2011 to advise on the new Agency, will present its final report by the end of this month and I look forward to addressing its recommendations relating to vision, governance and scope-of-services, such that the Agency is established and up-and-running next January 2013.” In the report the authors remark that “a key issue to be emphasised is the vulnerability of these children”. The Minister responded stating: “Many of these individuals had extremely complex needs. There is no doubt that children in these circumstances sometimes have little to draw on, in terms of their own resilience, and limited positive experiences to allow them to cope with even the ordinary challenges they subsequently had to deal with. “The role of alcohol and drugs in Irish society plays heavily in the lives and deaths of many of the children and young people in this report, highlighting in the most serious way, our national problems with alcohol and drug abuse. I am committed to working with Minister Roisin Shortall and the relevant agencies on progressing a fresh new approach to identifying and addressing the hidden harm posed by substance misuse. Responding to the report Minister Fitzgerald also announced a number of other measures. The Minister accepted the essential criteria set out in the Report on developing an independent child death review structure and confirmed that she will be making an announcement on this in September. The Minister announced that HIQA will next month publish new National Standards for the Protection and Welfare of Children which will lay-out a new standards-led approach to enforcing a new culture of quality, effectiveness and accountability in Ireland’s child protection services. The Minister also commented on the concerns raised on aftercare in this report: “Young people with a need for aftercare should; and must, receive the support they require when they leave care. I believe the law needs to be strengthened in this regard, and with advice from the Attorney General, I will be proposing legislative change later this year, in the bill to establish the Child and Family Support Agency.” The Minister confirmed that along with Gordon Jeyes she is working to extend access to 24 hour social work assistance: “Child protection crises arise 24-7. So why should child protections services operate any differently?” The Minister concluded saying: “today is an especially difficult day for the families of the children in this report. We cannot change things for their children. However, I hope it is clear that already a great many changes have been put in train for other children because of what happened. I hope it is clear that this Government is committed to transparency and honesty about the challenges in getting children’s services right. Child protection remains a high priority on our agenda and changes at every level – policy, law, structures and individual practitioner - have happened and will continue to happen; and will make a difference for the future.”Social servicesAdolescent / youth (teenager / young person)IrelandRisk assessmentSocial workerrisk factorsChildHealth care deliveryHealth care quality controlFamily supportServices for family and children2012-06Government PublicationsReport

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Drugs and AlcoholService providers accredited in Community Reinforcement Approach.MartinKeaneauthorHealth care quality controlDrug or health care workerInformation transfer from research to practiceDublinCommunity-based treatment (primary care)2012-01Health Research BoardArticle

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Drugs and AlcoholVital signs: Taking the pulse of the addiction treatment profession.OliviaRyanauthorDeenaMurphyauthorLaurieKromauthorSince 2007, national reports sponsored by the US based Substance Abuse and Mental Health Services Administration (SAMHSA) have repeatedly identified a lack of nationally representative data describing the specialty workforce that serves individuals with substance use disorders (SUDs) (SAMHSA, 2006; Annapolis Coalition, 2007). These reports suggest that the dearth of nationally representative data negatively impacts the ability of SAMHSA and other federal agencies to institute meaningful workforce development programs for SUD professionals. In response, SAMHSA instructed the Addiction Technology Transfer Center (ATTC) Network to carry out a national workforce study. The purpose of the study is to inform the development of strategies to successfully prepare, recruit and retain a sufficient number of professionals able to effectively care for individuals with SUDs. This report presents the findings of the ATTC Network’s national study, Vital Signs: Taking the Pulse of the Addiction Treatment Profession. Although SAMHSA is the primary audience for the study’s findings, the ATTC Network expects that comprehensive, nationally representative data about the specialty SUD treatment workforce will be useful to Single State Agencies, provider and professional organizations, training and education entities, individuals in the workforce, and other stakeholders.Drug or health care workerHealth information and educationUnited StatesOrganisational developmentWorkforce / staff skills and training2012Addiction Technology Transfer Center National Office in residence at the University of Missouri-Kansas CityEvidence resource

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Drugs and AlcoholCan general practice help address youth mental health? A retrospective cross-sectional study in Dublin's south inner city.DConnollyauthorDLeahyauthorGerardBuryauthorBGavinauthorFMcNicholasauthorDMeagherauthorFDO'KellyauthorPWieheauthorWalterCullenauthorAIMS: With general practice potentially having an important role in early intervention of mental and substance use disorders among young people, we aim to explore this issue by determining the prevalence of psychological problems and general practice/health service utilization among young people attending general practice. METHODS: A retrospective cross-sectional study of patients attending three general practices in Dublin city. RESULTS: Among a sample of young people (mostly women, 44% general medical services (GMS) eligible), we observed considerable contact with general practice, both lifetime and for the 2 years of the study. The mean consultation rate was 3.9 consultations in 2 years and psychosocial issues (most commonly stress/anxiety and depression) were documented in 35% of cases. Identification of psychosocial issues was associated with GMS eligibility, three or more doctor consultations, and documentation of smoking and drinking status. CONCLUSIONS: Psychosocial issues are common among young people attending general practice and more work on their epidemiology and further identification in general practice are advocated.Drugs and alcohol in generalTobacco (cigarette smoking)Mental healthMental health careCommunity-based treatment (primary care)EpidemiologyDrug or health care workerDoctorDublin2012WileyArticle

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Drugs and AlcoholNational standards for safer better healthcare.The National Standards for Safer Better Health will provide the building blocks for a standards-driven health service, creating a common understanding of quality and safety. The standards will give healthcare providers a structure to systematically and continuously improve the safety and quality of services delivered. The National Standards will: • place patients at the heart of the care process • be a benchmark for change for safety • give patients a clear expectation of the standard of care they can expect to receive • ensure services will be clear on what is expected of them • provide a strategic approach to improving safety, quality and reliability in our health servicePatient care managementHealth care deliveryHealth care quality controlOrganisational developmentWorkforce / staff skills and trainingDrug or health care workerDoctorNurse2012Health Information and Quality AuthorityEvidence resource

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Drugs and AlcoholDrug use in pregnancy: challenges for health care workers.DeirdreCarmodyauthorNoreenGeogheganauthorRoseSheppardauthorEamonKeenanauthorMO'ConnellauthorA comparative study to examine maternal and neonatal outcomes of pregnant women from a case load of a Drug Liaison Midwife (DLM) over a six year period, 2002-2007, compared with a similar study carried out in 1999 (Scully et al 2004) in the same locality, Coombe Women and Infants University Hospital, Dublin (CWIUH). In this study, 436 women met the inclusion criteria. All women were engaged with the DLM and obstetric services. This research compared and contrasted the pattern of drugs used, methadone dosage, obstetrical attendance and neonatal outcome in this group of women. The majority of women were stable in their drug use, attended adequate antenatal care and had a positive neonatal outcome. Results illustrate the importance of a good partnership approach to improving the care for pregnant opiate-dependent women..Drug or health care workerIrelandPregnancyPregnant womanMedical careDrugs and alcohol effects and consequencesHealth care delivery2011Article

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Drugs and AlcoholEMCDDA manuals no 7. European drug prevention quality standards. A manual for prevention professionals.The common view of drug prevention, particularly in lay audiences, is that it consists of informing (generally warning) young people about the effects (most commonly the dangers) of drug use. Prevention is then often equated with (mass media)campaigns. However, there is currently no evidence to suggest that the sole provision of information on drug effects has an impact on drug use behaviour, or that mass media campaigns are cost-effective. In reality, the challenge of prevention lies in helping young people to adjust their behaviour, capacities, and wellbeing in fields of multiple influences such as social norms, interaction with peers, living conditions, and their own personality traits. This view is also reflected in current prevention approaches. To provide a simplified overview, environmental prevention strategies target social norms, universal prevention targets skills development and interaction with peers and social life, selective prevention focuses on living and social conditions, and indicated prevention facilitates dealing and coping with individual personality traits and psychopathology.Health services, drugs and alcohol researchDrugs and alcohol preventionPrevention approachWorkforce / staff skills and trainingPractice / clinical guidelinesDrug or health care workerEurope2011Publications Office of the European UnionEvidence resource

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Drugs and AlcoholNational quality standards framework (NQSF) for youth work.The NQSF is intended to be both practical and developmental, in that it will enable youth work organisations to assess service provision and to identify areas for development. As engagement in the NQSF is a continuous process, it is not expected that all organisations will be able to immediately and fully achieve all the standards as set out in this document. Neither is it the intention that the NQSF would require uniformity of provision. Rather, it aims to ensure that youth work providers continue to offer a rich and varied service, and commit to a process of continuous development through engagement in the NQSF. The NQSF is primarily a support and development tool for youth work organisations. Self-assessment is fundamental to the process. In addition, there is also an external assessment function, which serves to validate the self-assessment process and which is performed by VEC (Youth/Liaison) Officers for local youth work services or by the NQSF Standards Officer for national youth work organisations.Youth-club / cafe based preventionOrganisational developmentRecommendations or guidelinesAdolescent / youth (teenager / young person)Drug or health care workerIreland2010-07-27Office of the Minister for Children and Youth AffairsReport

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Drugs and AlcoholCompetencies for Canada’s substance abuse workforce.This report forms a supportive resource that identifies the technical and behavioural competencies required to perform effectively in the substance abuse field (from health promotion, support and outreach, counselling, withdrawal management, and supervision to administration and senior management). The competencies also apply to allied professionals (e.g., primary health care providers, enforcement officials, Elders, volunteers, and social workers) interacting with individuals who have substance abuse issues. National competencies for the specialized substance abuse field were identified as a critical need in the first-ever survey of the Canadian addiction treatment workforce in 2004. In response, the Canadian Centre on Substance Abuse, under the guidance of the National Advisory Group on Workforce Development, undertook to identify the technical and behavioural competencies needed by the substance abuse workforce. The goal of this project—comprised of Technical Competencies for Canada’s Substance Abuse Workforce, Behavioural Competencies for Canada’s Substance Abuse Workforce, and supporting tools—is to enhance professionalism in the field by providing resources to: • identify knowledge and skill sets for the substance abuse workforce and allied professionals • support employers in hiring, retention, and staff development • assist educators and trainers in developing strategies for learning • provide Canadians with a more consistent quality of service delivery from the substance abuse workforce.Drug or health care workerWorkforce / staff skills and trainingCanada2010Canadian Centre on Substance AbuseEvidence resource

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Drugs and AlcoholNational drugs rehabilitation framework document.JoeDoyleauthorJelenaIvanovicauthorDrug or health care workerIrelandRehabilitationHealth care programme or facilityHealth care delivery2010Health Services ExecutiveReport

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Drugs and AlcoholPredictors of role legitimacy and role adequacy of social workers working with substance-using clients.HildaLoughranauthorMelindaHohmanauthorDanielFinneganauthorRole adequacy (feeling knowledgeable about one's work) and role legitimacy (believing that one has the right to address certain client issues) have long been key theoretical constructs regarding explanations why various helping professionals are reluctant to address drug misuse problems with clients. This study examines these concepts in a sample of social workers and social work students. Using regression analysis, it was determined that the social workers who had more clients with drug problems, had taken a course in drug work and had support for their role were more likely to feel legitimate in their work with drug-using clients. Training in drug use identification and intervention, being male, having more clients with drug problems and role support predicted role adequacy. Having a Master's degree, work setting and job function were not related to role adequacy or role legitimacy. Implications for social work education are discussed.Mental healthSocial servicesMental health careIrelandEducation and trainingSocial worker2010OxfordArticle

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Drugs and AlcoholFrom Drugnet Europe.JoanMooreauthorDrugs and alcohol preventionPrison-based health servicePrisonDrug or health care workerPrison Inmate (prisoner)Europe2010Health Research BoardArticle

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Drugs and AlcoholAlcohol and other drugs workforce development issues and imperatives: setting the scene.Ann MarieRocheauthorKenPiddauthorThis document builds on the body of work undertaken by NCETA in relation to AOD workforce development over the past decade. This report has been prepared to inform the development of a National Alcohol and Other Drug (AOD) Workforce Development (WFD) Strategy. It describes the background, context and issues currently facing the AOD workforce and outlines steps for the development of a national strategy. The present document provides substantially broader data than previously available and incorporates new conceptual models of workforce development. This document is set out in two main parts – Part A and Part B, preceded by an executive summary that outlines recommendations for a national workforce development strategy. Part A also contains five chapters that address key elements of relevance to the development of national workforce development strategies. Each chapter ends with a summary and an outline of implications for a national workforce development strategy. The five chapters contained in Part A cover the following issues. Chapter 1: Workforce development an overview Provides an overview of why AOD workforce development is a priority. It details encouraging developments that have occurred to-date but also notes that a comprehensive and strategic approach executed at the national level has been missing to this point in time and is now pressingly required. Chapter 2: The wider context Highlights the importance of considering the wider workforce and service delivery system within which the AOD field operates and the relevance of this wider context to the development of a national workforce development strategy. It also outlines the need for a national strategy to be able to accommodate emerging trends and the adoption of evidence based practice. Chapter 3: Broadening the definition of workforce development Details a broad definition of workforce development that incorporates a systems approach to individual and organisational change is presented. This section also examines different models of workforce development and implications of these models for a national workforce development strategy. Chapter 4: The structure of the Australian AOD workforce Provides an overview of available data concerning the AOD workforce, identifies gaps in this data and underscores the importance of on-going workforce mapping and workforce planning for a national workforce development strategy. Chapter 5: Contemporary workforce development issues Describes current workforce development challenges facing the AOD field. These include issues such as recruitment and retention, education and training, professional development, accreditation and minimum qualifications, salaries and awards, leadership and management, workplace support and worker wellbeing. Part B contains five chapters which provide more detailed data from the 13 surveys undertaken to date that profile the AOD specialist and generalist workforces.Drug or health care workerOrganisational developmentEducation and trainingAustraliaWork-related drugs and alcohol issueWorkforce / staff skills and training2010National Centre for Education and Training on AddictionEvidence resource

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Drugs and AlcoholeLearning: Managing knowledge to improve social care.AndrewBoothauthorRowanPurdyauthorSandraWardauthorDionLindsayauthorThis elearning programme sets out to help front line social workers gain a basic understanding of the principles and practice of knowledge management, as well as organise and manage their knowledge and information as effectively as possible. Modules: • A day in the life - Day to day work contexts for knowledge in a professional practice, deciding how useful different sources of knowledge are. • Types of knowledge - The knowledge cycle and framework • How do I organise my knowledge? - How the knowledge can be organised and accessed and the consequences of poor organisation • When knowledge gaps occur - Strategies for managing deficiencies in organising and managing knowledge • Sharing knowledge in teams - Strategies for improving knowledge managing in teams • Using technology to improve knowledge sharing - Choosing appropriate technology from the range available • Knowledge beyond the team - Approaches to locating external knowledge resources and building a personal list • Knowledge is our business - Identifying the culture enabling knowledge sharing • Innovation through technology - Web 2.0 and user centred practiceHealth information and educationInformation disseminationInformation transfer from research to practiceDrug or health care workerSocial workerUnited Kingdom2010Social Care Institute for ExcellenceEvidence resource

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Drugs and AlcoholATLAS on substance use (2010). Resources for the prevention and treatment of substance use disorders.The ATLAS on Substance Use provides a structured description of available prevention and treatment resources for substance use disorders in WHO regions, different income economies and the world. Chapter 1 introduces the epidemiological aspects of substance use disorders and provides information on the level of need for treatment. Chapter 2 illustrates health service resources. Data on the implementation of pharmacological treatment for substance use disorders are presented in chapter 3. Chapter 4 covers human resource aspects. Policy and legal resources are discussed in chapter 5, before concluding with resources for the prevention of substance use in chapter 6. The ATLAS report is based on a survey instrument and has been accomplished through collaboration with WHO regional and country offices, national focal points and a number of leading experts in the field of psychoactive substance use.Drug or health care workerTreatment outcomeDrugs and alcohol disorder treatment methodCommunity-based preventionHealth care quality controlPrevention outcomePsychosocial treatment methodInternational aspectsTreatment factorsDrugs and alcohol preventionPolicy on drugs and alcohol2010World Health OrganizationEvidence resource

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Drugs and AlcoholmhGAP intervention guide for mental, neurological and substance use disorders in non-specialized health settings.The mhGAP Intervention Guide (mhGAP-IG) for mental, neurological and substance use disorders for non-specialist health settings, is a technical tool developed by WHO to assist in implementation of mhGAP. The Intervention Guide has been developed through a systematic review of evidence followed by an international consultative and participatory process. The mhGAP-IG presents integrated management of priority conditions using protocols for clinical decision-making. The priority conditions included are: depression, psychosis, bipolar disorders, epilepsy, developmental and behavioural disorders in children and adolescents, dementia, alcohol use disorders, drug use disorders, self-harm/suicide and other significant emotional or medically unexplained complaints. The mhGAP-IG is a model guide and has been developed for use by health-care providers working in non-specialized health-care settings after adaptation for national and local needs. For access to the mhGAP Evidence Centre please click the related URL link below.Drug or health care workerMental health careDrugs and alcohol disorder treatment methodPractice / clinical guidelinesPatient care managementDrugs and alcohol related mental disorderHealth care quality controlPsychosocial treatment methodDrugs and alcohol in generalInternational aspectsGeneral treatment method concepts2010WHOEvidence resource

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