 Wulf Livingston  Glyndwr University  Grasping the Nettle - Birmingham May 2012

O The one that’s there O The one you encouraged to use O The one others use O The one that makes sense for you setting O The one you like O More than one in different contexts

 The appropriateness of initiatives will vary from one local area to another and inclusion of local initiatives, or actions, on this site does not represent endorsement by the Alcohol Learning Centre or Department of Health 22/04/12

O There maybe no need, the likelihood is O –it is already there and/or O - (you have no choice), you just need to find out what is already being used

 Identification  Communication – like for like  Referral Criteria 22/04/12

 Health and social care, criminal justice and community and voluntary sector professionals in both NHS and non-NHS settings who regularly come into contact with people who may be at risk of harm from the amount of alcohol they drink.  Use validated screening tools appropriate to the setting, for example the Alcohol Use Disorders Identification Test (AUDIT). Where time is limited they can use an abbreviated version such as AUDIT-Consumption (AUDIT-C). The Fast Alcohol Screening Test (FAST), the Paddington Alcohol Test (PAT) or Single Alcohol Screening Questionnaire (SASQ) may be more appropriate for an emergency department setting. 22/04/12

 Birmingham DAAT uses AUDIT Distinguishes with a score of 19 A-Team or Aquarius/Nursing Team  DAATs – have alcohol –leads, strategies  Mindful of language – tools, screening, brief advice, extended brief intervention (what roles are being identified for your agency)

 Babies, Bowels, Benefits  Why not booze 22/04/12

O If you consistently work with one agency or one client group, then there maybe a specific tool they prefer (common language and understanding) O A & E and other clinical setting –FAST (or PAT, MASQ) O Probation –AUDIT full (*) O G-MAST/G-MAST long for Older Peoples Drinking Clinical/Health –Partial Social (Time) -Full Young People

22/04/12

Epidermis Hair Follicle Sebaceous Gland Biological fluids Drug

Self Reporting is (90% +) reliable live in their own home; are employed full time; are over the age of 30; have not self-reported a drug dependence in the past 12 months; and have not self-reported being engaged in the drug market in the past 30 days have been detained for a property offence; have had prior contact with the criminal justice system over the past year; self-report being on drugs at time of arrest; self-report being engaged in the drug market in the past 30 days; self-report being drug dependent in the past 12 months; and self-report being in drug or alcohol treatment during their lifetime MacGregor, K. and Makkai, T (2003) Self reported drug use, how prevalent is under- reporting? Australian Institute of Criminology trends and issues in crime and criminal justice 260 Canberra)

O AUDIT – The gold standard Ask about Use Related Problems Advice on Action Congratulate those drinking at lower- risk levels and encourage them to keep to this level of alcohol consumption Deliver ‘simple brief advice’ to those drinking above lower-risk levels Encourage referral to a specialist treatment service for those showing signs of dependence and/or in need of more in-depth treatment.  Do you?  How much and often?  What effects?  Have you thought about?

O Feedback on their alcohol and drug use must be accurate and positive O Responsibility – be clear that the choice to change and responsibility for it rests with the client O Advice giving – give clear information and advice O Menu – offer a choice of change options O Empathy – adopt an empathic counselling style O Self-efficacy – promote independence

 ask your agency  ask your local alcohol and drug team, voluntary agency, Probation, general practitioner…find out what others are they using  Find – Alcohol Liaison Officer  ask is the Drug and Alcohol Action Team (DAAT) leading on a local universal approach…..find out if the local strategy specifies an approach 22/04/12

 ics/Browse/BriefAdvice/ ics/Browse/BriefAdvice/  Bliss, D. L. and Pecukonis, E. (2009) Screening and Brief Intervention Practice Model for Social Workers in Non-Substance- Abuse Practice Settings Journal of Social Work Practice in the Addictions, 9:21-4O. (Limitations but explores the issues) 22/04/12