|Dealing with intoxication covers a broad
range of behaviours. While the steps outlined below may provide a useful clinical
background, specific procedures for particular situations and professional judgment are
the corner stones of intervention.
These steps are also available as a PowerPoint
presentation @ Dealing with
|Breath (don't panic)
may trigger a range of different emotional reactions in staff (eg fear, anger,
disappointment, confusion, humour). Breathing and other short-term management strategies
will help in providing the most effective approach.
|Assess the situation
Assessment of the degree of intoxication, safety for self, others
and the client within the context of the overall situation is important. This requires
sound professional judgment matched with knowledge of stated policy and procedures.
If possible, engage the support of other staff to help manage the situation where
Consider calling emergency services such as police and/or ambulance - better safe than
|Similar to disruptive
While intoxication may not prove to be disruptive, many of the
strategies in dealing with disruptive incidents apply to dealing with intoxication. This
includes having set procedures, policy and practice guidelines, general client management
principles, along with post-incident debriefing and review procedures.
|Assume impaired control
should be prepared for possible unpredictable behaviour. However, do not assume
that those who are intoxicated have totally lost control. The use of clear messages
may help to manage impaired impulse and cognitive control while allowing a degree of
|Identify substance(s) if
While part of initial assessment, more detailed information should
be gathered after safety issues have been addressed. Knowing how much, when and how
substances were used as well as if more substances will be used may be helpful in
anticipating if the client will become further intoxicated or not.
|Duty of care
a car while intoxicated can be dangerous for the client or others. Similarly, death from
overdose, accidents and domestic violence may be prevented with careful client management.
Once again, having set procedures (such as an observation room or referral to sobering-up
facilities) negotiation with the client and family and use of professional judgment will
|Limit therapy (if possible)
clients feel the need for substance use as a way to help cope with therapeutic engagement.
However, conducting assessments or therapy is difficult if the client is intoxicated.
Rather, staff should listen respectfully to what the client has to say but limit
engagement in therapeutic discussion. This will help to foster a positive client/therapist
relationship. Therapeutic issues should be postponed to the next appointment with the
client being reminded to attend not intoxicated.
Should any statutory issues require attention and the person is mildly intoxicated, the
provision of appropriate information by way of brochures, written material (if literate)
and an appointment card, may be useful.
|What to say and How to say it
|Introduce self and role
the client know exactly who you are will help to reinstate lost boundaries and remind the
client of why they are here. This is also a polite thing to do which models the type of
behaviour you will expect from the client.
the client's name reminds both the client and the worker of the person behind the
intoxication. Again, this simple strategy models appropriate behaviour.
|Tell them where they are
and what's happening
Those who are very intoxicated are likely to have very
impaired cognitive ability. They may require your ability to think clearly and process
information to help orientate and ground them. Providing this sense of control may help
reduce negative behaviour which sometimes accompanies feelings of loss of control.
simple sentences are more likely to be understood. However, it is important not to appear
condescending. Where required, speech should be polite, but firm, directive and not
ambiguous. Where necessary, ask the client to reflect back to you what they have heard and
clarify any misunderstandings.