types of treatment

advice & information

Advice and information is provided by New Highway, but can also be obtained initially from GP surgeries and accident & emergency departments. The assistance and support that New Highway can provide includes:

• information about drugs and alcohol, and their effects
• advice on reducing and giving up drugs and alcohol
• information on reducing the potential harm from drug misuse, such as injecting more safely and preventing overdose
• how to get help for drug & alcohol problems
• how to get help for other problems, such as housing and sexual health
• information for carers, partners and families of drug users.

harm reduction

Mostly harm reduction is about preventing diseases passed on by contaminated blood (particularly HIV and hepatitis infections), and preventing overdose and drug-related death. All drug treatment services, whether residential or based in the community, will mostly provide this as a core service, examples of harm reduction;

• needle exchange provision, which distribute and dispose of needles, syringes and other injecting equipment
• advice and support on injecting more safely, injecting less and preventing other people from starting to inject
• advice and information on preventing infections associated with drug misuse, particularly hepatitis A, B and C, and HIV (blood-borne viruses)
• testing, advice, information and counselling around hepatitis and HIV
• access to treatment for hepatitis B, C and HIV infection
• advice and support on preventing overdose and drug-related death
• assessing clients and referring them to other treatment services if necessary.

community prescribing

Community prescribing is specialised drug treatment in the context of a care plan. It is provided as part of primary care, by a GP with an interest in drug misuse or a doctor in a specialist drug treatment service. Where service users receive the treatment may depend on the seriousness of their problems, how long they have been in treatment or how stable they are, community prescribing incorporates;

• stabilising service user on substitute drugs
• prescribing substitute drugs, such as methadone and buprenorphine, for a sustained period (maintenance prescribing)
• prescribing for withdrawal (community detoxification)
• prescribing to prevent relapse
• stabilisation and withdrawal from sedatives, such as valium and temazepam
• prescribing for assisted withdrawal from alcohol, where appropriate
• treatment for stimulant users, which may include prescribing to help relieve symptoms
• non-medical prescribing (by nurses or pharmacists).

counselling and psychological support

Counselling is not to be confused with basic advice and informal support. It should be carried out by a trained and competent professional and be included in a client’s care plan. Counselling needs to be formal structured – with clearly defined treatment plans and goals – and regularly reviewed. Psychological therapies can include cognitive behaviour therapy (CBT), coping skills, relapse prevention therapy, motivational interventions and family therapies.

structured day programmes

Structured day programmes usually run a set series of activities for a fixed period of time (for example 12 weeks). Service users attend these services according to a set attendance level (usually 3-5 days a week), as set out in their care plans. There is a timetable of activities, which will either be the same for everyone, or be set individually for clients according to their needs. Programmes often include group work, counselling, education and life skills, and creative activities.

detox

This is known medically as “assisted withdrawal” and involves a stay as an inpatient. Most people receiving detox are given medication to help clear their bodies of drugs. The inpatient treatment can also include stabilisation on substitute medication, emergency medical care for drug users in crisis, and in some cases treatment for stimulant users. As well as the inpatient treatment itself, other services may be available, such as preparation for entering inpatient treatment, counselling, help with alcohol problems, harm reduction and treatment for blood-borne viruses. Inpatient treatment is provided in:

• general hospital wards (usually psychiatric wards)
• specialist drug inpatient units (a whole ward or unit specifically for drug treatment)
• residential rehab units with attached detox units to help people come off drugs before entering the main rehab programme.

Service users are normally admitted into inpatient treatment through community drug services. it is important that people leaving inpatient treatment receive proper support to maintain the positive changes they have made and prevent themselves relapsing.

rehab

Residential rehabilitation (rehab) usually involves service user staying in a facility for weeks or months and a complete break from their current circumstances. Rehabs normally have a mixture of group work, counselling and other practical and vocational activities. There are several types of facilities;

• traditional rehab units, with programmes to suit the needs of different service users. different units have different approaches, for example therapeutic communities and the 12-Step programmes used by alcoholics anonymous & narcotics anonymous. most of these take clients from all over the country
• crisis intervention units (usually in urban areas) that help people in drug-related crisis. these are generally shorter stay units
• residential treatment programmes for specific client groups, for example pregnant women, people with liver problems and clients with mental illness. these may require joint initiatives between specialist drug services and other specialist inpatient units
• "second stage” or “move-on” supported accommodation, where some clients go to after rehab
• other supported accommodation, with the rehabilitation interventions (therapeutic drug-related and non-drug-related interventions) provided at a different nearby site(s).

As with inpatient treatment, service users will generally access rehab through community services. People entering rehab will usually have gone through detox before entering. This detox could be somewhere else – for example in a hospital, or in the community – or at the rehab itself, if it has an attached detox unit.

aftercare

Aftercare is support that is planned for when service users leave structured treatment. The aim is to maintain the positive developments clients have made in their treatment, and help them return to normal life. Examples include help with housing, education, employment, general health care and relapse prevention