Home > Clinical guidelines for nursing and midwifery practice in New South Wales: identifying and responding to drug and alcohol issues.

These guidelines provide nurses and midwives with support and a benchmark for quality drug and alcohol use assessment and care in daily practice.

Table of contents:
1 Principles of practice ....................... 7
2 Overview and general guidelines .............. 8
3 Communication and special population groups....11
4 Drug and alcohol use assessment .......... 16
5 Opportunistic intervention ................... 20
6 Managing intoxication ........................ 21
7 Managing overdose ............................ 26
8 Managing withdrawal .......................... 29

9 The drugs .....................................32
9.1 Alcohol
9.2 Opioids (heroin, methadone etc)
9.3 Benzodiazepines (diazepam – valium, oxazepam – serepax etc)
9.4 Psychostimulants (amphetamines – speed, methamphetamines – ice, crystal etc)
9.5 Cannabis
9.6 Tobacco
9.7 Hallucinogens
9.8 Solvents (inhalants, volatile substances)
9.9 Ketamine
9.10 Gamma hydroxybutyrate (GHB)
9.11 Anabolic androgenic steroids (AAS)

10. Pharmacotherapies for dependence ...... 67
10.1 Opioid pharmacotherapies
• Methadone
• Buprenorphine
• Naltrexone
10.2 Alcohol pharmacotherapies
• Acamprosate
• Naltrexone
• Disulfiram

Appendices ............................... 73
Appendix 1. Glasgow Coma Scale
Appendix 2. Clinical Institute Withdrawal Assessment for Alcohol (revised) (CIWA-Ar)
Appendix 3. Alcohol Withdrawal Scale (AWS)
Appendix 4. Clinical Opiate Withdrawal Assessment Scale (COWS)
Appendix 5. Cannabis Withdrawal Assessment Scale
Appendix 6. Street names of drugs
Appendix 7. Drug interactions with methadone
Screening Tools, Handouts .......................... 83
Alcohol use disorders identification test screening instrument (AUDIT)
Drug Quiz — ASSIST (Cannabis)
Drug Quiz — ASSIST (Psychostimulants)
Drug Quiz — ASSIST (Heroin)
Making changes
Minimising harm from alcohol or other drug use