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Nine Drug Treatment Steps

This guide outlines nine key steps you might take in dealing with client drug use issues. While you may choose not to follow each of the steps in all of your cases, it may serve as a useful check-list. 

1Raise the issue
2. Assessment
3. Motivational interviewing
4. Negotiate treatment goals
5. Relapse prevention & relapse management
6. Harm reduction
7. Maximise supports
8. Follow-up & review
9. ? Community action

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Possible Sequence of Approach

bullet 1. Raise the issue
bullet Screening questions
bullet Index of suspicion (signs of drug use)
bullet Any connections between presenting issue & drug use?
bullet Any connections between drug use and ability to care for and protect children?
bullet Manage intoxication

2. Assessment

bullet Their story: "can you tell me about your drug use?"
bullet Relationship to presenting issue
bullet Using drug use models & frameworks, ask about drug issues relating to:
bullet Liver, Lover, Livelihood & Law
bullet Intoxication, Regular Use & Dependence
bullet Stage of change
bullet Drug history including consumption levels and periods of controlled use, abstinence
bullet Typical day-to-day impact & management of drug use (eg functional analysis)
bullet Children, Partner, Parent/Carer require intervention such as protection and/or support?
bullet Risk assessment required? (eg child protection, family violence)
bullet Referral required?

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3.  Motivational Interviewing

bullet Identify issue for change
bullet Assess importance & confidence
bullet Ask about positives
bullet Ask about less positives
bullet Compare with life goals
bullet Ask for a decision
bullet Set a short-term goal

4. Negotiate treatment goals

bullet Abstinence or controlled use
bullet Reduction of drug-related problems
bullet Other associated goals (ie improved family functioning/child safety, manage anxiety, depression, anger, accommodation, relationship, life skills, etc)
bullet Referral/shared case management and/or brief intervention
bullet Detoxification required? (residential or non-residential)
bullet Specific, Meaningful, Assessable, Realistic, Timed (SMART) Goal-Setting

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5. Relapse prevention & relapse management

bullet Manage high risk situations
bullet Manage cravings & impulse control
bullet Refusal skills
bullet Develop competing behaviours
bullet Maintain vigilance
bullet Deal with resolution breakdown and 'slips'
bullet Plan for and Manage safety issues (child protection, family violence, overdose, unsafe injecting, etc)

6. Harm reduction

Can and should be considered whether or not reduced drug use is a goal.

Identify key areas of harm and safety
Negotiate Problem Solving Steps to identify, manage and review drug-related harm

Some major areas of drug-related harm include:

bullet Overdose
bullet Suicide
bullet Violence  (Family - spouse abuse, child to parent, child to child)
bullet Child neglect & abuse
bullet Blood borne viruses (needle sharing, immunisation, testing, safer sex)
bullet Motor vehicle accidents

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7. Maximise supports

bullet Family, friends & 'buddy' supports
bullet Child care supports & safe care
bullet Professional Supports (including telephone supports - ie ADIS)
bullet Self-help booklets & written material
bullet Ongoing referral to specalists within your agency, or to other agencies where indicated

8. Follow-up and review

bullet Ongoing re-assessment
bullet Telephone or face-to-face follow-up
bullet Supervision
bullet Review overall outcome & closure

9. Community action?

bullet Inter-agency links & shared case management requirements
bullet Lobby/advocacy functions
bullet Resource development (eg programs, services, facilities)
bullet Some examples:
bullet Click here for the Community Partnerships Kit & examples of projects funded by the Community Partnerships Initiative. 
bullet Contact Local Drug Action Group (WA only)
bullet Policy changes required? (within & between agencies)
bullet Anything else?


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Complete Downloadable Manuals

A Summary of the Evidence Based Practice Indicators for AOD Interventions
Several booklets in PDF form from the WADASO web, based on material by Ali Dale & Ali Marsh
Pub by Best Practice in AOD Working Group - W. Australia

An Introduction to Working With Alcohol and Other Drug Issues
Eastern (Victoria) Drug & Alcohol Services - Funded by Dept Human Services Victoria Australia (1999)
Download the MS Word Version 1.2 MB - 49 pages

Drug & Alcohol Manual for Generalist Health & Welfare Workers PDF 1.1 MB - 116 pages
Portland District Hospital & Barwon Health, Funded by Dept Human Services Victoria Australia (1999)

Principles of Drug Addiction Treatment: A Research-Based Guide PDF 184 KB - 56 pages
National Institute on Drug Abuse and the National Institutes of Health (1999) - USA

Click here or the icon below for free Acrobat Reader for PDF files
Click the PDF icon to get Acrobat Reader required to read PDF files [Free]

Related Internet Site

(ADF, Victoria)


Other DrugNet Pages in this Subject Heading

Introduction ] [ Treatment Steps ] Brief Intervention ] Raise the Issue ] Motivational Interviewing ] Intoxication ] Relapse ] Harm Reduction ] Referral ] Withdrawal ] Treatment Options ] Involuntary Clients ] Self-help ] 12 Steps AA/NA ] Overdose ] NIDA Publications ] Adolescents ]

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