Families Guide to Drug and Alcohol Services

Families Guide to

Drug and Alcohol Services

ConCERnEd about anothER PERSon’S dRuG oR alCohol uSE?

Call fREEPhonE hElPlInE 0800 652 9664

Support for you

“ Parents, partners, grandparents, siblings and children of

drug users can often feel very helpless as they see another

family member suffering.”

Mood swings can mean family members feel like they’re ‘walking on eggshells’ – a tightrope between wanting to express how they’re feeling and wanting to keep quiet for fear of sparking a row. Often family members can feel isolated, as it can be difficult to talk with friends or others in the family. If you are affected by another person’s drug or alcohol use, emotionally, psychologically, physically or financially, you are entitled to support in your own right.

Professional service

Pressure Point Family Project (part of Pathways to Recovery)

Pressure Point is for family members and friends who need help and support to cope with someone else’s drug or alcohol use – whether the use is experimental, recreational or dependant. The project provides:

• A free and confidential service. • A safe and supportive environment.

• Someone to talk to who will listen and understand. • Ideas about how to manage the situation.

• Access to one-to-one counselling and support. • Local Family Support groups.

• Signposting to other services.

The project can also offer joint sessions with the substance user and their recovery worker, where the substance user agrees. Call free on 0800 652 9664 or phone

01905 746 879 (24-hour answering service).

Peer support groups

Whilst no two experiences are the same, many people prefer to speak to others who have been through similar experiences, either over the phone or in groups. There are groups in Worcestershire which provide one-to-one support by phone or in person, family meetings or groups.

Parents and Partners Against Drugs (PAD)

Monthly meetings in Worcester, or a friendly chat. Please call 01386 860 338. Substance Abuse Family and Friends Enterprise (SAFE)

Talk on the phone, or meet up for a coffee.

Call or text 07938 382 498 or email [email protected]. Families Unite

Meetings in Redditch or talk on the phone 07855 690 918. Alternatively email [email protected]

The future

It may sometimes seem that there can be no end to the situation you are in, that you will never be able to move on. Many people do manage to move on – either with professional help, or the support of others who have been through it. Here are a few of the experiences of other people:

“

Engaging with PAD had a very positive effect in my life. It was really

good meeting with people who have the same problems and are

going through the same, being able to speak without judgement,

listening to what others have been through, and knowing I am not

alone. I also learnt a lot about how to deal with situations I found

myself in. PAD can’t solve your problems but they can help with how

you deal with them. It helps you to see light at the end of the tunnel.

I have been on a very long journey and have no idea where it will

end, but interacting with any of the services provided has helped me

and continues to help me.

“

“

It took so much for me to ask for help as I felt disloyal and worried

about the consequences. They were dark difficult years. I had no idea

I was the light at the end of my own tunnel.

“

“

Whilst I am very happy that my husband is sober and that many

things improve each new day, it can also bring its challenges. I was

not responsible for his drinking and I am not responsible for his

sobriety. I can accept that I need to live my life and allow him his own

path, so my happiness and serenity need not be reliant on whether

he drinks or not.

“

Support for children and young people

The Family Project also has a service specifically to support children or young people affected by someone else’s drug or alcohol use called Inside Out.

Inside Out works to build resilience and protective factors in children and young people, helping reduce the risks of harm – including the risk of the

young person developing a drug or alcohol problem.

Using a variety of ‘young person friendly’ tools they can provide a confidential, supportive service, individually tailored to support the young person’s needs.

Inside Out will also refer and support access to other, community-based, sources of support.

Drug and Alcohol Services in Worcestershire

Pathways to Recovery

Pathways is an integrated drug and alcohol treatment service, providing a wide range of support for adults and young people. The service is confidential, and treatment is tailored to meet individual needs. Service users will also benefit from access to a wide range of other agencies that can support them on their own personal journey of recovery.

Pathways offers:

• Specialist advice and information.

• Needle exchange and health promotion.

• Psychosocial and medical assessment.

• Testing for blood borne viruses and vaccinations for Hepatitis B.

• Medical interventions including methadone and buprenorphine prescribing.

• Community home detoxification.

• GP shared care.

• Action planning, care coordination and key work.

• Group work – including relapse prevention.

• Referral and assessment for residential rehabilitation and detoxification.

• Drug Interventions Programme, supporting alcohol and substance users involved in the criminal justice system.

• Harm reduction and abstinence-based treatment.

• Life skills training.

Assessment and referral

Anyone can self-refer to Pathways, or be referred by another agency, by calling 0808 178 3295. They will then be given an initial assessment of their needs and supported to develop a recovery plan.

They will be allocated a recovery worker, who will work alongside them to provide ongoing support, coordination of other services that they can use, and regular reviews to assess their progress and build their motivation.

Pathways’ ethos is to treat the whole person, so their recovery plan will cover a wide range of issues such as alcohol and substance use, physical and mental wellbeing, housing, education and training, relationships and social support. Many people are enjoying the benefits of being in recovery each and every day.

Adfam is a national organisation that provides training and support to professionals and families. With over 25 years’ experience supporting people with a drug user in the family, Adfam is uniquely positioned to deliver targeted and effective training that properly understands the needs and experiences of families. Call 020 7553 7640

Visit www.adfam.org.uk

Al-Anon Family Groups hold regular meetings where members share their own experience of living with alcoholism. Al-Anon doesn’t offer advice or counselling, but members give each other understanding, strength and hope.

Call helpline 020 7403 0888. Visit www.al-anonuk.org.uk

Worcestershire County Council Carers’ Unit offers information and advice for professionals and carers relating to all aspects of carers assessments and carer support services.

Call 0800 389 2896

Carers Action Worcestershire - a consortium of three charities providing information, advice and support for the 60,000 unpaid adult carers in Worcestershire, including those caring for people with addictions. Call helpline 0300 012 4272 (24/7) Visit www.carersworcs.org.uk

Worcestershire Carers’ Unit

How can drug or alcohol users access our services?

Anyone can self-refer by telephone, letter or by dropping in. We are not solely for people with problems, and we won’t assume a person has a problem just because they use drugs or alcohol.

For any form of intervention to be effective, the person seeking help with a drug or alcohol problem needs to be committed to changing their lifestyle. Recovery is not something that is done to someone, it is a process or journey towards a new lifestyle that a person can find with support. Many people do achieve recovery, and we can put people in touch others who have already travelled that road, and can support and inspire people.

If you want contact details for any of our services, please phone our helpline:

0800 652 9664

What the treatment services will tell you

“ Without the trust to talk openly, our service users would not

progress in understanding their motivation to use. Without

written permission from the service user, the treatment services

will not be able to share information with loved ones.”

This can be frustrating – especially when you want to know how the person you care for is progressing. If you speak to the substance user and explain your concern, they may be willing for the service to share some information with you. They may even be willing to attend a joint session with you and a recovery worker to discuss the best way forward for everybody.

What is drug or alcohol treatment all about?

“ Why doesn’t the person just stop using? If they did, everything

would be okay!”

For many drug and alcohol users, stopping is only the first challenge, and remaining abstinent is an even greater one.

This is because substance use often has a purpose for the person – a value, often hidden, that the user themselves may be unaware of. For example, to reduce anxiety or increase confidence.

To complicate things further, there are often two components of drug and alcohol dependence:

• Physical: This where – after repeated use – the user’s body has adapted to a substance, so they have withdrawal symptoms when trying to stop using and can’t function properly without it.

• Psychological: Substance use behaviour may develop for many reasons, with psychological dependency occuring when substance use is seen by the user as a solution to problems. This idea becomes more important than any of the harmful results associated with the substance use behaviour. Sometimes, until the physical dependency is addressed, it is too hard for the person to address the psychological dependency; they need to be stable enough to consider changing how they think about themselves and the world. If someone has been drinking every day for several months or years, and they notice that they need more alcohol to stop feeling shaky and sweaty, or they need to drink when they wake up, they will need specialist advice to help to safely stop drinking.

For drug users, Pathways to Recovery

can prescribe and supervise substitute medication to stop withdrawal and balance the body; and then provide the support necessary to enable the person to understand the purpose of substance use in their lives, their reasons for using, and to find new ways of living.

Recovery

In order to achieve and maintain recovery, people need more than treatment alone. Meaningful activities and peer support and mentoring can really make a difference. Recovery workers can help clients to access these opportunities.

A new start

Pathways works closely with Stonham Breakthrough Service. When a client is ready, Stonham BreakthroughService can help them to access appropriate education, training, employment and volunteering opportunities, as well as housing support.

The process of change

This process of change can be painful, and it is common for people to feel that is just too difficult, and want to give up. This is when it can be particularly difficult for family members and partners. The joy of seeing someone make a commitment to change can be replaced with despair if the drug or alcohol user starts using again.

This can be a crucial stage. ‘Lapses’ are often part of the process, and if considered properly can be valuable learning experiences to understand more about the cause of the substance use.

It is important to understand that ‘lapses’ do not equal failure – but are an opportunity, if addressed in a positive way.

Alcohol intoxication

Here are some basic – but essential – procedures you can follow in a situation when someone is drunk:

• Don’t communicate any feelings of anxiety to the person and don’t ridicule or threaten him/her.

• Before approaching or touching the person, explain what you intend to do in a direct and reassuring manner. Listen carefully to the person’s responses to you. • Keep the person still and comfortable. Don’t let him/her walk unattended. • Don’t administer any food, drink or medications, including aspirin or vitamins,

because these may provoke vomiting or stomach pain.

• Don’t let the person sleep on his/her back. If vomit is inhaled into the lungs, it may result in choking and possibly death. To avoid this, place the person on his/her side, with one arm extended above the head; this is known as the recovery position.

• Keep a sober person nearby to watch for signs of trouble with breathing,

fits, vomiting or other distress. Observe the intoxicated person for at least an hour.

If the person can talk to you ask:

• How much has he/she had to drink and how long ago?

• What has he/she had to eat? (Because of the possibility of vomiting.) • Whether he/she has fallen, hit their head, or been injured in any other way. • Whether any other drugs (prescribed or unprescribed) have been taken.

Alcohol poisoning

Alcohol poisoning can occur when large amounts of alcohol are drunk, often in binges (single sessions) in which a lot of alcohol is drunk in a short space of time. Alcohol poisoning may be associated with legally or illegally produced alcoholic drinks. See http://www.nhs.uk/conditions/alcohol-poisoning/Pages/Introduction.aspx

for more information and click on checklist for symptoms.

What to look out for:

• Vomiting. • Heavy sweating.

• Heavy, noisy, breathing, sometimes snoring. • Loss of consciousness.

• Evidence of alcohol having been consumed, e.g. smell on breath, empty bottles, and witnesses who can give an account of how much alcohol has been consumed.

Take action:

• Perform ABC (check Airways, Breathing and Circulation) of resuscitation and prepare to resuscitate. Ring for help (999).

• Place in the recovery position. This is important. Even conscious victims may slip into unconsciousness and it is very common for victims of alcohol poisoning to die by choking on their own vomit.

• Check airways, breathing and pulse every 3 to 4 minutes, until help arrives.

Alcohol withdrawal

After stopping drinking alcohol a person may experience the following:

• Within 8-12 hours: tremulousness (shakiness). • Within 8-24 hours: withdrawal seizures i.e. fits. • Within 24-48 hours: hallucinations.

Please visit your GP and Pathways to Recovery for advice before you decide to stop drinking. Pathways to Recovery are able to advise regarding further help and assessment for detoxification.

Tremulousness, (shakiness) and profuse sweating can occur after suddenly stopping or reducing alcohol intake. It is important to emphasise that it can be unsafe to suddenly stop drinking without professional support when significant alcohol dependence is present.

Delirium tremens (DTs) is a true medical emergency as the condition carries the risk of death if left untreated. DTs can occur in dependent drinkers who suddenly stop drinking and produces severe shakes, sweats, hallucinations, delusions and fits, 24-48 hours after the sudden change in drinking pattern. If someone you know shows these symptoms an emergency Doctor or ambulance should be called or the person should be brought to A&E.

If signs of delirium (confusion) are noted by observers or family members an ambulance should be called.

Signs to look out for:

• Tremor (shaking).

• Disorientation, agitation or apathy.

• Profuse sweating, confusion and hallucinations.

Wernickes Encephalopathy (wet brain)

Brain damage caused by vitamin B and thiamine deficiency, related to poor diet and heavy drinking. If untreated this condition can become permanent. Wernicke’s Encephalopathy is commonly caused by thiamine deficiency resultant from poor diet on a background of continued heavy drinking, however it should be noted that it can also be caused by other medical conditions. For example, some gastric conditions or conditions which induce repetitive vomiting.

There are 3 main symptoms which are commonly associated with a Wernicke’s episode –

• Acute confusion – onset can be rapid.

• Ataxia/gait problems. This is walking with widely spaced feet and slow reactions to changing the direction of walking, which may be observed to develop more slowly over time.

• Nystagmus. This is involuntary movements of the eyes, which may look as if they are twitching within the eye socket – more rapid onset.

In practice, should sudden onset of one of these three symptoms be observed in someone, then GP or emergency services should be contacted. It is important to advise paramedics/emergency medical staff that the individual in question has a history of poor nutrition and heavy drinking.

For further information regarding alcohol misuse please see

Alcohol, drugs and domestic abuse

There are many forms of domestic abuse, not all of which are physical. Domestic abuse involves the misuse of power and is based on a range of control tactics, which include physical, sexual, psychological, social or economic abuse or neglect of an individual. Although NOT the cause, alcohol and drugs can be major contributory factors in domestically abusive relationships.

What can I do?

If you are in an abusive relationship or know someone who may be:

• Acknowledge it is happening

• Take Action – get help and support

Where can I get help?

Call in confidence the Worcestershire Domestic Abuse Helpline 0800 980 3331 or visit www.worcestershire.gov.uk/wfada

In an Emergency Call 999.

In an emergency...

Symptoms of sedative overdose are commonly:

• Small pupils.

• Not waking in response to being shaken, or talked at.

• Lips turning blue.

• Stopping breathing.

• Vomiting.

It is important to respond quickly.

Call 999 for an ambulance.

Police will not routinely accompany an ambulance unless they believe a child or paramedics may be at risk. Ensure you give the address where the overdosed person is situated.

Paramedics may be able to administer medicine that ‘brings the person round’ very quickly. This medicine can also wear off quickly so, be prepared to encourage the person to go to hospital so that they can be monitored carefully.

Whilst waiting for an ambulance, DO NOT make a person vomit unless instructed to do so by a health professional.

Place the person in the recovery position, ensuring their airway is clear.

Useful numbers

Worcestershire Pathways to Recovery 0808 178 3295

Pressure Point Family Project 01905 746 789

Pressure Point/Inside Out helpline 0800 652 9664

Stonham Breakthrough 0845 155 0395

WCC Carers Unit 01905 728 824

Carers Action Worcestershire 0300 012 4272

PEER SuPPoRt GRouPS

PAD (Parents and Partners Against Drugs) 01386 860 338

Families Unite 07855 690 918

SAFE (Substance Abuse Family and Friends Enterprise) 07938 382 498

Al-Anon Family Groups 020 7403 0888

Alcoholics Anonymous 0845 769 7555 InfoRmatIon Worcestershire DAAT 01905 766735 FRANK 0800 77 66 00 Alcohol Concern 020 7264 0510 Adfam 020 7553 7640 NHS Direct 0845 4647

Drug and Alcohol Action Team

Worcestershire DAAT is a multi-agency partnership of Chief Officers or their representatives from a range of agencies, tasked with addressing the misuse of drugs and alcohol and implementing the national strategies associated with this work to:

‘ Reduce the harm that drugs and alcohol cause to individuals, families and communities within Worcestershire’.

Based at County Hall, they can be contacted on:

Tel: 01905 766735 or Fax: 01905 766930 Email: [email protected]

Worcestershire

Worcestershire Health and Care