Presentation on theme: "Alcohol Identification and Brief Advice Training"— Presentation transcript:
1 Alcohol Identification and Brief Advice Training Barnsley Social Care Workforce Development UnitAlcohol Identification and Brief Advice Training
2 The aim of this training session is to give you Information about alcohol units and the harm caused by alcoholthe knowledge to identify where alcohol misuse might be a issue in the Service Users journeythe tools required to assess the extent to which the service user’s alcohol use is harmfulthe confidence to conduct a structured brief intervention aimed at reducing the level of the service user’s alcohol consumption
3 How much do you know about Alcohol ? ????? Let’s try a Quiz ???
4 Recommended Limits Adult women 2-3 units per day. Adult men 3-4 units per dayYoung people under the age of 18, should normally drink less than adult men and womenHigher risk drinking is defined as regularly drinking over 6 units per day for women (over 35 units per week) and over 8 units per day for men (over 50 units per week).
6 Strength (ABV) x Volume (ml) = No. of units UNIT CALCULATORWork out your alcohol units for yourself with this sum:Strength (ABV) x Volume (ml) = No. of units1000E.g. Pint of Stella: x 568 ÷ = Large glass of wine: x 250 ÷ = 3.00
7 Modern Drinking Habits Pubs use larger wine glasses than they did ten to fifteen years ago.People tend to use larger glasses at home and are unlikely to use measuresHigher strength drinks are now commonplace and available very cheaplyAlcopops have revolutionized drinking for younger people
8 Alcohol – What are the Risks NUMEROUS!!!!Alcohol consumption is NEVER considered to be completely risk free
9 Effects of Alcohol Increases in: And many more …………… Depression Reduced Effectiveness of medicationReduced performance at workPuts individuals at risk of injury from physical violenceWeight Gain ImpotenceSleep disordersIncreased accidents/injuriesAlcohol PoisoningLoss of consciousnessCancersMemory LossDementiaLiver diseaseInflammation of the stomach/ulcersLow MoodRisky BehaviourIncreases in:Domestic ViolenceRapePublic DisorderViolence against strangersRelationship BreakdownUnemploymentPoor/reduced performance at work or homeAnd many more ……………
10 Health implications of hazardous & harmful alcohol use.
12 ALCOHOL – THE WIDER SOCIAL IMPACT Alcohol misuse contributes to around 1.2 million incidents of violent crime200 premature deaths each year40% of Domestic Violence Cases6% of all road casualtiesUp to 2.6 million children live with a hazardous drinkerUp to 17million working days are lost annually through alcohol related absences70% of A&E Admissions each weekendAlcohol misuse costs the NHS £ 2.6 billion each year
13 Legal implications of drinking: Drinking & driving, resulting in a 12/12 ban, or up to £5000 in fines or up to 6/12 in prison.Drinking & anti-social behaviour, resulting in a £50-80 fine for buying/drinking alcohol under 18, being drunk, vomiting/urinating in the street, harassing someone or drinking in a ‘no alcohol’ public area.
14 Indicators of Alcohol Misuse Gut ProblemsProblems sleepingSnoringUnusual level of falls/accidentsWounds that won’t healUnable to lose weightSocial irresponsibility (promiscuity/fighting)Early morning drinkingBin full of bottles/cansMemory problemsAlcohol ‘hidden’ around the homeLying about/hiding alcohol useRelationship problemsProblems holding a job or keeping appointmentsDrinking aloneBoasting about drinking levels
15 ALCOHOL AND YOUR JOBHave you ever broached the subject of alcohol with a service user?What response did you get?Did you feel comfortable?How do you feel about doing Identification and Brief Advice for alcohol?Readiness to change will affect a service users response
16 MOST COMMON ALCOHOL USE QUESTIONNAIRES AUDITAUDIT-CFASTSASQAUDIT - PC
20 RISK LEVELSLower risk - drinking implies that no level of alcohol consumption is completely safe. The context can determine the level of risk, for example drinking and driving.Increasing Risk - regularly drinking more than 2-3 units a day for a woman and more than 3-4 units a day for a man.Higher Risk - regularly drinking more than 6 units per day for women or more than 8 units per day for men. Or more than 35 units per week (women) and more than 50 units per week (men).Binge Drinking - regularly drinking more than 6 units for women and more than 8 units for men i.e. twice the daily limit on a regular basis.
21 WHO Termshazardous drinkers - those drinking above recognized ‘sensible’ levels, but not yet experiencing harm.Harmful drinkers - those drinking above ‘sensible’ levels and currently experiencing harm (excluding dependence).These terms are used by the WHO but are not recommended for use by the Department of Health because they are considered to be diagnostic
22 WHAT IS A BRIEF INTERVENTION? A short, evidence-based, structured conversation about a health issue with a service user that seeks in a non-confrontational way to motivate and support the individual to think about and/or plan behaviour changeIt’s Brief! Should take 5 – 15 minutes.
23 AIMS OF IBATo reduce the burden of alcohol related injuries and disease on the NHS and societyTo inform service users of the health risks associated with drinkingTo determine which service users health could be improved by reducing drinkingTo encourage service users to think more carefully about how their drinking might adversely affect their client journey
24 Brief Interventions…… Have been recommended due to an increase in alcohol consumptionProvide early interventions, not designed to deal with dependant drinkersMay be opportunistic or targetedAre a structured conversation – not just a discussionShould be used with an alcohol screening toolMay motivate increasing or higher risk drinkers to change their drinking behaviourAre more effective than no interventionDo make a difference!
25 IBA IS:OpportunisticBased on adviceAn Intervention lasting between 5 and 15 minutesFlexible –with or without formal follow-upIBA ISN’TSpecialist CounsellingConfrontationalA route to abstinenceA way to treat service users who are alcohol dependent
26 Listening Skills A good listener: Focuses and makes eye contact Nods and smilesAsks open questionsReflects on what’s been saidHelps the individual explore issuesEmphasises that responsibility lies with the individualAllows silencesUses a clear voiceSummarisesConcentratesProvides structureAvoids physical barriersChecks and clarifies understandingA poor listener:Interrupts or talks too muchTells their own storiesGives their own opinionRushes in with solutions/tries to ‘fix’Gives unsolicited advice or ordersDoesn’t admit not knowing all the answersThinks of next question without listeningConcentrates on the problem and not the personFidgets or fiddlesLooks away/looks bored/clock watchesIs condescending or patronisinigJumps to conclusions
27 ESSENTIAL ELEMENTS TO BRIEF INTERVENTION (FRAMES) Feedback - about personal risk due to current drinking. Do they know how many units they drink and the associate risk?Responsibility - rests with the individual, drinking is by choice and the responsibility to change lies with the individual.Advice - on how to change drinking behaviour, cut down or abstain.Menu – give options for change, offering alternative goals & strategies.Empathy, listening reflectively without trying to persuade or confront self-efficacy, encourage optimism.Self-efficacy (building confidence) – an interviewing style that increases a persons own belief in their ability to change
28 Empathy Empathy isn’t: Empathy is: Sympathy Curing or telling Rescuing Constant QuestioningEmpathy is:Active Uninterrupted listeningAccepting the personChallenging behaviourAbout strengthening relationships
29 ...and each of these is more than one unit This is one unit...For more detailed information on calculating units see -There are times when you will be at risk even after one or two units. For example, with strenuous exercise, operating heavy machinery, driving or if you are on certain medication.If you are pregnant or trying to conceive, it is recommended that you avoid drinking alcohol. But if you do drink, it should be no more than 1-2 units once or twice a week and avoid getting drunk.Your screening score suggests you are drinking at a rate that increases your risk of harm and you might be at risk of problems in the future.What do you think?How many units did you drink today?Half pint of regular beer, lager or cider1 very small glass of wine1 single measure of spirits1 small glass of sherry1 single measure of aperitifs(9%)...and each of these is more than one unit3A pint of regular beer, lager or ciderA pint of “strong”/ ”premium” beer, lager or ciderAlcopop or a 275ml bottle of regular lager440ml can of “regular” lager or cider440ml can of “super strength” lager250ml glass of wine (12%)Bottle of wine“regular”(12%)RiskMenWomenCommon EffectsLower RiskNo more than 3-4 units per day on a regular basisNo more than 2-3 units per day on a regular basisIncreased relaxationSociabilityReduced risk of heart disease (for men over 40 and post menopausal women)Increasing RiskMore than 3-4 units per day on a regular basisMore than 2-3 units per day on a regular basisProgressively increasing risk of:Low energyMemory lossRelationship problemsDepressionInsomnia•Impotence•InjuryAlcohol dependence•High blood pressure•Liver disease•CancerHigher RiskMore than 8 units per day on a regular basis or more than 50 units per weekMore than 6 units per day on a regular basis or more than 35 units per week
30 What is your personal target? The benefits of cutting downPsychological/Social/FinancialImproved moodImproved relationshipsReduced risks of drink drivingSave moneyPhysicalSleep betterMore energyLose weightNo hangoversReduced risk of injuryImproved memoryBetter physical shapeReduced risk of high blood pressureReduced risk of cancerReduced risks of liver diseaseReduced risks of brain damageWhat’s everyone else like?% of Adult PopulationWhat targets should you aim for?MenShould not regularly drink more than 3–4 units of alcohol a day.WomenShould not regularly drink more than 2–3 units a day‘Regularly’ means drinking every day or most days of the week.You should also take a break for 48 hours after a heavy session to let your body recover.Making your planWhen bored or stressed have a workout instead of drinkingAvoid going to the pub after workPlan activities and tasks at those times you would usually drinkWhen you do drink, set yourself a limit and stick to itHave your first drink after starting to eatQuench your thirst with non-alcohol drinks before and in-between alcoholic drinksAvoid drinking in rounds or in large groupsSwitch to low alcohol beer/lagerAvoid or limit the time spent with “heavy” drinking friendsWhat is your personal target?This brief advice is based on the “How Much Is Too Much?” Simple Structured Advice Intervention Tool, developed by Newcastle University and the Drink Less materials originally developed at the University of Sydney as part of a W.H.O. collaborative study.
31 WHEN TO REFER SERVICE USERS High Level of Alcohol Related harmWhere the individual is an increasing or higher risk drinker, who has not responded to previous brief intervention and advice, and who wishes to receive further help with their alcohol problems.score of 20 or more on the full AUDIT questionnaireSevere alcohol-related problems or risk of such problems, for example:ViolencePossible loss of job or familyObvious signs of physical dependence, for example:Withdrawal symptomsWithdrawal relief or avoidance drinkingVery high toleranceMemory blackouts
32 Who to refer Services Users to: The Barnsley Treatment System9-10 Burleigh CourtBarnsleyS70 1XY