This is an important part of our alcohol assessment. This evidence-based test focuses only on drug use. This test addresses the use of both prescription and over-the-counter meds, and the use of controlled substances.
It is also another question screening tool used during drug assessments. It consists of just six questions. They are very effective for identifying at-risk teens and young adults. Alcohol and drug brief advice typically takes 5 to 10 minutes. Brief advice is delivered based on the core principles of motivational interviewing MI.
Your aim is to evoke answers that will help your service user to gain insight into their current situation and options for change. The goal of brief advice is to reduce the risk of harm from tobacco smoking and alcohol consumption and drug use. SMART goals are:. Small goals often short-term are more likely to be effective than significant, longer-term goals.
Your service users are more likely to realise their goals if they develop the plan themselves. SMART goals following alcohol, drug and tobacco screening could focus on:.
There are widely-used, evidence-based models for delivering alcohol and tobacco brief advice, which are outlined below.
Very brief advice VBA for smoking aims to identify service users who smoke and support them to make a quit attempt. You can provide VBA in as little as 30 seconds. The intervention is made up of 3 core components: ask, advise and act. Service users who have a mental health condition and attempt to quit smoking, supported or unsupported, should have the dosage of their medications reviewed. This is because some psychotropic medications are affected by smoking and service users taking these medications may be able to have their dosage reduced.
The Maudsley Prescribing Guidelines in Psychiatry gives details about psychotropic medications known to be affected by smoking and provides actions to take when a service user on these medications stops or starts smoking. These are:. You can also share relevant information about the risks associated with their current alcohol and drug use. Responsibility: emphasise that their smoking, drinking or drug use is their own responsibility.
Advice: give advice on reduction or explicit direction to change, but only when the service user requests it or gives you permission to do so. Menu of options: explore the options for change.
Empathy: adopt a warm, reflective and understanding approach. Self-efficacy: encourage optimism about the behaviour change. The NHS alcohol brief advice tool can help you to structure alcohol brief advice. This tool outlines:. The cannabis health check-up tool can help you to structure cannabis brief advice.
It outlines:. You can find detailed information on illicit drugs and medicines that are commonly used not as prescribed, including the associated mental and physical health risks, on the FRANK website.
Clinical guidelines recommend advising service users not to stop using alcohol or drugs if there are concerns that they are highly dependent due to the risk of withdrawal. The specialist assessment will determine if they are dependent, their level of dependence and the risk of withdrawal. You should seek specialist assessment from a drug and alcohol treatment service, hospital alcohol care team ACT or doctor or nurse with appropriate specialist training.
This will depend on the level of risk associated with their drug and alcohol use. Further assessment could include:. Depending on your level of training and competence, you should consider offering an evidence-based treatment intervention as part of your care plan.
This could include motivational enhancement interventions, motivational interviewing, and pharmacotherapy. NICE guidance on the prevention of alcohol use disorders recommends that an extended brief intervention should be delivered where brief advice does not lead to a reduction in higher risk drinking. Specialist drug and alcohol treatment services can support and guide other professionals to deliver evidence-based treatment interventions. PHE guidance on co-occurring mental health conditions and substance use disorders outlines the need for agreed pathways which will help multiple agencies work together to deliver care.
This will check for signs of cirrhosis or advanced liver fibrosis. This is in line with the NICE guidance on cirrhosis in over 16s. Obesity induced fatty liver can progress to cirrhosis and liver failure, but obesity can also make the impact of alcohol consumption on the liver worse.
The effect of a combination of high BMI and alcohol is greater than the combined effect of the two separately. In simple terms, for a person with a BMI of over 35, the risk of liver disease doubles with any level of alcohol consumption. It is important that people with high BMI, particularly those with obesity induced fatty liver, are asked about their alcohol consumption.
This should be followed by brief advice or an active referral into specialist alcohol treatment, as appropriate. Referral pathways between local health and social care providers and specialist drug and alcohol treatment and recovery services should be clearly agreed and mutually understood.
If this is not the case, you can find local specialist alcohol and drug treatment and stop smoking support:. Referral into specialist treatment should not be a one-off action. An active referral will help your service user to get specialist support and treatment. An active referral involves:. Most drug and alcohol services accept self-referrals and offer drop-in assessment sessions, where you do not need an appointment.
If you remain in contact with a service user who was identified as having higher risk or possibly dependent alcohol or drug use, or who is a current tobacco smoker, you should use the ASSIST-Lite screening tool again at a future one-to-one or review session.
This allows you to assess any changes to their alcohol and drug use and tobacco smoking since your last meeting. This includes e-learning and instructional films. So, the recommended actions featured in the training films are different from those included in the UK versions of the tool.
The NHS alcohol brief advice tool will help you to deliver brief advice on alcohol. PHE published Alcohol: applying All Our Health to help health and social care professionals understand alcohol harm prevention and think about local resources that can help people whose drinking carries health risks.
The NHS website offers advice and information on getting help to address drug use. PHE published Misuse of illicit drugs and medicines: applying All Our Health to help health and social care professionals identify, prevent and reduce drug-related harm, and identify local resources and services that can help those who use drugs.
The NHS website can also help you to find local drug and alcohol services. PHE published Stop smoking options: guidance for conversations with patients , which helps clinicians talk to service users about the different treatment options for stopping smoking. PHE published Smoking and tobacco: applying All Our Health to help health and social care professionals understand the activities and interventions that support smokers to stop smoking, so they can think about the local resources and services that could help their service users to quit.
Health and social care professionals can also access training resources to develop skills in motivating and supporting smokers to quit. HEE provides a free e-learning course that covers both alcohol and tobacco brief advice. HEE also provides a range of comprehensive e-learning courses on alcohol identification and brief advice. The courses include evidence from more than 60 controlled trials over 30 years.
There are courses for different settings, including hospitals, primary care, community pharmacy and dental teams. The National Centre for Smoking Cessation and Training provides free e-learning courses for delivering very brief advice on stopping smoking. It also provides resources focused on supporting stopping smoking in secondary care, mental health and pregnancy services.
PHE published guidance on commissioning and providing better care for people with co-occurring mental health, and alcohol and drug use conditions. PHE published Health matters on smoking and mental health.
This edition of Health Matters focuses on smoking among people with a range of mental health conditions, from low mood to more severe conditions like schizophrenia and bipolar disorder. One You offers advice and information on cutting back on alcohol.
The Have a Word alcohol unit wheel is an interactive tool to help calculate the number of units and calories in alcoholic drinks consumed. The NHS website includes information about alcohol , including units, risks, binge drinking, the health benefits of cutting down and tips for cutting down. The NHS Drink Free Days app helps people to pick their days to skip alcohol and get practical support to stick with it.
FRANK is a free drug advice service that is primarily aimed at young people and parents. Mutual aid services offer peer support and connection with a community of people who are in recovery. Mutual aid can supplement a structured alcohol or drug treatment programme.
Local mutual aid groups may include:. NHS Better Health offers a variety of stop smoking aids, specialist support and links to other resources including the Smokefree app which provides daily support and motivation.
To help us improve GOV. It will take only 2 minutes to fill in. Cookies on GOV. UK We use some essential cookies to make this website work. Accept additional cookies Reject additional cookies View cookies. Hide this message. Public Health England. Introduction Health and social care professionals are well placed to provide interventions targeted at all substances. Supporting your service users to reduce drug use, quit smoking and drink less alcohol will : reduce premature mortality and morbidity reduce the burden on the NHS reduce health inequalities improve health and mental health treatment outcomes The ASSIST-Lite will help you to identify alcohol, drug and tobacco smoking-related risk and deliver appropriate evidence-based interventions.
Illicit drugs Estimates show that around 1 in 11 16 to 59 years olds in England and Wales have used an illicit drug in the last year , with 1 in 3 using at some point during their lifetime. Tobacco Tobacco smoking is the leading cause of preventable illness and premature death in England. Mental health impact of alcohol and drug use and tobacco smoking Drugs and alcohol It is very common for people to experience problems with their mental health and alcohol or drug use at the same time.
National guidance on commissioning and providing better care for people with co-occurring conditions states that: people are often unable to access care from services when intoxicated or experiencing mental health crisis mental health services sometimes exclude people because of co-occurring alcohol or drug use people diagnosed with serious mental illness may be unable to access alcohol and drug services due to the severity of their mental illness Tobacco People with mental health problems, including anxiety , depression and schizophrenia , are much more likely to smoke and tend to smoke more heavily than the general population.
In to , smoking prevalence was: Evidence Alcohol and drug screening tools can help professionals identify those needing intervention. Guidelines and organisational standards Using the ASSIST-Lite screening tool will help you adhere to the following National Institute for Health and Care Excellence NICE clinical guidance on alcohol and drug use, smoking and mental health conditions: Alcohol-use disorders: prevention , Alcohol-use disorders: diagnosis, assessment and management of harmful drinking high-risk drinking and alcohol dependence recommend routine identification and advice for those drinking at levels that significantly increase their risk of harm.
This should occur during contact with statutory and other services, including mental health services. The NHS Standard Contract requires that providers: deliver alcohol identification and brief advice deliver very brief advice VBA to all patients who smoke identify inpatients who smoke tobacco and offer brief advice or referral to specialist stop smoking support Delivery of VBA for smoking cessation also forms part of the NHS Long Term Plan.
Deliver an appropriate level of intervention based on the level of risk identified for each substance. Review risk at a future appointment. Step 1: screening Using the ASSIST-Lite tool will help you identify service users whose alcohol and drug use and tobacco smoking may be increasing their risk of physical, psychological or social harm.
NICE guidance on targeted interventions recommends that you routinely: screen all adults for alcohol misuse ask all adults about their smoking status assess whether people in groups at risk are vulnerable to drug misuse you can do this by using the drug screening questions in the ASSIST-Lite NICE guidance on psychosocial interventions recommends routine drug screening in settings where drug misuse is common, such as mental health and criminal justice services.
The tool has the following structure: Question 1 covers tobacco. Questions 2 to 4 cover alcohol. Questions 5 to 7 cover cannabis. Questions 8 to 10 cover stimulants. Questions 11 to 13 cover sedatives and sleeping medications. Questions 14 to16 cover opioids. Questions 17 to 18 cover other psychoactive substances including use of medications not as prescribed.
0コメント