AOD Alert coworkers Don’t assume – smell = intoxication, slurred speech, stumbling = intoxication. Proceed as normal but observe Write down any info given.

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Presentation transcript:

AOD Alert coworkers Don’t assume – smell = intoxication, slurred speech, stumbling = intoxication. Proceed as normal but observe Write down any info given for them to take If aggressive or not able to be interviewed encourage them to come back another time. Consult if they might need medical

Collaborative case management Due to the nature of drug and alcohol using experience it is often the case that more than one worker is involved with a client. The workers communicate their actions to each other and the client Case worker meetings are held where all involved can be present The various skills of the workers and their agencies are recognised and respected An example of collaborative case management may be; support from teachers at the young person’s school, a child protection case manager, a youth drug and alcohol outreach worker and a housing support worker. This team can be very effective in supporting the client providing communication is maintained between all parties.

Goals Relating to AOD Use Unchanged continuation of substance use Continuation of current substance use, but implementing harm reduction strategies Cessation of one substance, whilst continuing the same pattern of use with other/s Reduction of substance use Controlled drug use Complete abstinence

Treatment Options Given the diverse range of organisations providing the various treatment options there will be differences in the way the service is provided from organisation to organisation. It is important that workers be aware of specific details of programs in their area. Questions such as: Target Group Referral and Assessment Process Restrictions on access – eg. co-occurring disorders, age, geographic limitations, How the service operates - rules & conditions Types of drug use that the service addresses Accessibility of location Gender and cultural considerations Duration of treatment Hours of operation Cost to client Philosophical and Theoretical Framework

The AOD Service System Counseling and Support Counselling, Consultancy & Continuing Care Peer Support Outreach NSP Day Programs Withdrawal Services Residential Withdrawal Home Based Withdrawal Hospital Rural Withdrawal Withdrawal – Public and Private Outpatient Withdrawal Rehabilitation and Post Withdrawal Residential Rehabilitation Supported Accommodation Peer Support Pharmacotherapies Opiates Nicotine Alcohol Information Services Telephone websites Client Group Specific Services AOD forensic services

The AOD Service System Counseling and Support Counselling, Consultancy & Continuing Care Peer Support Outreach NSP Day Programs Withdrawal Services Residential Withdrawal Home Based Withdrawal Hospital Rural Withdrawal Withdrawal – Public and Private Outpatient Withdrawal Rehabilitation and Post Withdrawal Residential Rehabilitation Supported Accommodation Peer Support Pharmacotherapies Opiates Nicotine Alcohol Information Services Telephone websites Client Group Specific Services AOD forensic services

Information Services Telephone Direct line or (24 hour service for counseling, information and referral services) Poisons Information Line YSAS Line hour information, counseling and referral to YSAS and other youth specific services throughout Victoria. DACAS or (24 hour advice on clinical management of drug and alcohol issues) usually used by health professionals Drug Info (24 hour info services about drugs and alcohol) Websites Better Health Channel (Directories will give you contacts for various agencies) Drug Info Clearing Housewww.druginfo.adf.org.au/ Australian Drug Foundation Information and resourceswww.adf.org.au/ Australian Drug Information Network (part of ADF) information, services and resources (including information in other languages)

The AOD Service System Counseling and Support Counselling, Consultancy & Continuing Care Peer Support Outreach NSP Day Programs Withdrawal Services Residential Withdrawal Home Based Withdrawal Hospital Rural Withdrawal Withdrawal – Public and Private Outpatient Withdrawal Rehabilitation and Post Withdrawal Residential Rehabilitation Supported Accommodation Peer Support Pharmacotherapies Opiates Nicotine Alcohol Information Services Telephone websites Client Group Specific Services AOD forensic services

Counseling, Consultancy & Continuing Care Target group are people who have AOD problems and require treatment and support to manage these, either by maintaining change or controlling their drug use. Provide a variety of counseling interventions including individual and group interventions, relapse prevention, cognitive-behavioural interventions, motivational interviewing, controlled use interventions and psychotherapy. Provide case management and planning for clients. Assessment and Individual treatment plans. Can also provide services to families of clients. Tend to be based in community health settings and rely on the client being able to attend appointments in this type of setting.

Peer Support and Self-help groups A person with a drug problem can gain insights into their drug use by talking to others who have been in a similar situation. Many self-help groups can also offer support services. Alcoholics Anonymouswww.alcoholicsanonymous.org.auwww.alcoholicsanonymous.org.au Narcotics Anonymouswww.naoz.org.auwww.naoz.org.au Women for sobriety Self Held Addiction Resource Centre (SHARC) Phone: Family and Friends Support Group Voice / land line

Outreach An outreach service provides assessment, support and on-going case coordination to young people with alcohol and drug problems, in their own environment. Provide assessment, support and case management on an outreach basis to young people in their own environment. Undertake interventions such as; harm reduction education, controlled use, relapse prevention, motivational interviewing, cognitive behavioural interventions and referral. Because of the structure of Youth Outreach the client can be offered a consistency of care model where, the worker that they engage with whilst drug using could remain the same through their journey of referral to withdrawal, rehabilitation and other intervention programs. Outreach programs are offered to young people and in the Koori Community.

Needle and syringe programs (NSP) These programs are offered across the state in a range of settings, including community health services, drug treatment agencies, youth organisations, pharmacies, and NSP agencies, hospital accident and emergency units. NSP’s can provide their services in a variety of ways; Fixed Site; Mobile Services; Disposal Hotline; Outreach; and Outreach Foot Patrol. Peak bodies in relation to NSP are; AnexPhone: (61 3) Web: Anex (the Association for Prevention and Harm Reduction (the Association for Prevention and Harm Reduction Programs) VivaidsPhone: (61 3) Web: VIVAIDS Victorian Drug User Victorian Drug User Group Hep C council of VictoriaPhone: Web: Victorian Aids CouncilPhone: (61 3) Web:

Day Programs To provide support to young people that are currently linked or involved in treatment with youth alcohol and drug treatment service/s and to compliment these services in order to provide a pathway for the client to post treatment. The target group is any young person aged years who may be either linked or involved in treatment with the alcohol and drug treatment sector year olds who are not involved in formal education may access the programs, where appropriate. Provide short-term life-skills, vocational/employment and recreational based programs. Provide support and assistance to access other services which assist the client on a pathway to sustained non-drug abusing. Participate, in consultation with the relevant A&D clinician, an Individual Treatment Plan with the client. Provide referral for client's carers and families.

The AOD Service System Counseling and Support Counselling, Consultancy & Continuing Care Peer Support Outreach NSP Day Programs Withdrawal Services Residential Withdrawal Home Based Withdrawal Hospital Rural Withdrawal Withdrawal – Public and Private Outpatient Withdrawal Rehabilitation and Post Withdrawal Residential Rehabilitation Supported Accommodation Peer Support Pharmacotherapies Opiates Nicotine Alcohol Information Services Telephone websites Client Group Specific Services AOD forensic services

Withdrawal services - Adult Residential Withdrawal Residential Withdrawal Services provide alcohol and drug withdrawal to people through a community residential drug withdrawal service. The treatment emphasis is on a short length of stay, usually 6 days. Adult units provide; structured assessments of drug consumption, health and psychological factors, case management of clients including an Individual Treatment Plan and Discharge Plan to be developed in conjunction with the client, medical and psychiatric care, 24 hour supportive care, provide support services to carers and family (if appropriate). Usually an activity based program.

Adult Residential Withdrawal Units DASWest 3-7 Eleanor Street, FOOTSCRAY 3011 Phone: (03) Windana Society 88 Alma Road, ST KILDA EAST 3183, Phone: (03) Uniting Care Moreland Hall 26 Jessie St, Coburg 3058, Phone: (03) South East Alcohol & Drug Services (SEADS) Drug Withdrawal Unit 229 Thomas Street DANDENONG 3175 Phone: (03) DePaul St Vincent's Hospital Community Residential Drug & Alcohol Withdrawal Unit 38 Fitzroy Street, FITZROY 3065 Phone: (03)

Withdrawal services - Youth Residential Withdrawal Provides a short term intensive support, time out and drug withdrawal service to young people in a residential setting (7 – 14 days). Youth residential withdrawal services are provided to young people aged 12 to 21 years, who are drug using in a manner that is causing significant physical, psychological and social harm. There is also the capacity to provide respite care to young people. Provide a safe, secure and drug free environment, with twenty-four hour support, a recreation and activities based program that both educates and motivates and includes harm minimisation strategies.

Youth Residential Withdrawal Units YSAS Eastern Residential Withdrawal Unit Glen Iris Phone: (03) YSAS Fitzroy Residential Withdrawal Unit Gertrude Street Fitzroy Phone: (03) YSAS Geelong Residential Withdrawal Unit Geelong Phone: (03) Windana Youth Community House (WYCH) 39A Clow Street, Dandenong Phone: (03) DASWest 3-7 Eleanor Street, FOOTSCRAY 3011 Phone: (03) Uniting Care Moreland Hall 26 Jessie Street, Moreland Phone: (03)

Withdrawal services - Home based withdrawal services The home based withdrawal nurse (along with a GP) will assess the person and design a withdrawal process and medication regime (if required) for the person based on their needs and situation. Stability of the client and their living environment is the key.  Monitor and support the person during the process.  Supervise medication distribution and health care.  Provide after hours support and advice.  Develop an Individual Treatment Plan with the client.  Provide appropriate services, support and referral to family members and supports. Facilitate links with other services for post-withdrawal support. Provision of harm minimisation strategies This service is provided to both adults and youth.

Home based withdrawal services Salvation Army Bridge Centre Home-Based Withdrawal 12 Chapel Street ST KILDA Phone: (03) Alcohol & Drug Program Drug Withdrawal Team 228 Pakington Street GEELONG WEST Phone: (03) Barwon South West Youth Alliance Halstead Place GEELONG WEST Phone: (03) DasWest, Home-Based Withdrawal Service Western Hospital 3-7 Eleanor Street FOOTSCRAY Phone: (03) Women & Children's Drug & Alcohol Service Home-Based Drug Withdrawal Service 129 Durham Road SUNSHINE Phone: (03) Peninsula Drug & Alcohol Program Outpatient & Home Withdrawal Service Hastings Road FRANKSTON Phone: (03) Access Alcohol & Other Drug Services Home-Based & Outpatient Drug Withdrawal Address: 1st Floor, Upton House, Thames Street BOX HILL Phone: (03) South East Alcohol & Drug Services Home-Based Withdrawal Programs Address: Level 2, 229 Thomas Street DANDENONG Phone: (03) Uniting Care Moreland Hall Home-Based Withdrawal Program Address: 26 Jessie Street MORELAND Phone: (03) Western Region Alcohol & Drug Centre Youth Home-Based Withdrawal Address: 26 Fairy Street WARRNAMBOOL Phone: (03) YSAS Home-Based Withdrawal Support Service BOX HILL Phone: (03) FRANKSTON Phone: (03) DANDENONG Phone: (03) BENDIGO Phone: (03) CITY NORTH WEST Phone: (03)

Withdrawal services - Hospital Some hospitals have allocated beds for medically assisted withdrawal. Rural withdrawal In country Victoria, general practitioners and health services often provide treatment and support involving a short hospital stay (where required) with a period of home based withdrawal. Outpatient Withdrawal This is available to people whose withdrawal can be appropriately managed without admission to a residential service and involves a series of intensive individual consultations over a short period, followed by ongoing counseling and support to help complete the withdrawal.

Public and private withdrawal Private detoxification facilities usually require full payment or, private health insurance, they tend to be expensive. Warburton Clinic - Health Scope - Alcohol & Drug Clinic Donna Buang Road Warburton Phone: Pinelodge Clinic 1480 Heatherton Road Dandenong Phone : Epworth Hospital - Drug And Alcohol Unit 34 Erin Street Richmond Phone: Vaucluse Hospital - 82 Moreland Road Brunswick Phone:

The AOD Service System Counseling and Support Counselling, Consultancy & Continuing Care Peer Support Outreach NSP Day Programs Withdrawal Services Residential Withdrawal Home Based Withdrawal Hospital Rural Withdrawal Withdrawal – Public and Private Outpatient Withdrawal Rehabilitation and Post Withdrawal Residential Rehabilitation Supported Accommodation Peer Support Pharmacotherapies Opiates Nicotine Alcohol Information Services Telephone websites Client Group Specific Services AOD forensic services

Pharmacotherapies The use of substitution pharmacotherapies is advocated to: enable clients to stabilize their lives improve health reduce the spread of blood borne communicable diseases reduce deaths associated with substances reduce crime that may be associated with drug use facilitate improvement in social functions.

Main Pharmacotherapies Opiates: Methadone Buprenorphine Naltrexone Nicotine: Nicotine Patches, Nicorettes, etc Zyban Alcohol: Naltrexone Antabuse Campral

The AOD Service System Counseling and Support Counselling, Consultancy & Continuing Care Peer Support Outreach NSP Day Programs Withdrawal Services Residential Withdrawal Home Based Withdrawal Hospital Rural Withdrawal Withdrawal – Public and Private Outpatient Withdrawal Rehabilitation and Post Withdrawal Residential Rehabilitation Supported Accommodation Peer Support Pharmacotherapies Opiates Nicotine Alcohol Information Services Telephone websites Client Group Specific Services AOD forensic services

Rehabilitation and Post Withdrawal – Residential Rehabilitation Residential rehabilitation services provide a 24 hour staffed residential treatment programs, length of stay varies from 3 months to 2 years. They provide a range of interventions which aim to ensure lasting change and to assist reintegration into community living. Programs are usually intensive and their focus will be different depending on the philosophies of the agency. All should contain a range of treatment interventions, including behavioural treatment approaches, social and community living skills training relevant to the client's needs, counseling, group work and relapse prevention. The Basin Salvation Army

Rehabilitation and Post Withdrawal – Youth Residential Rehabilitation Birribi is a 15-bed residential rehabilitation program for young people aged 16 to 20 years who have experienced problematic drug use. The program is located in Eltham, on 14 acres. It is 24 hour staffed.The average program stay is 4 months, during which the young person progresses through six stages: The program comprises a mix of group and individual therapy, recreational, vocational and educational activities, with an overall focus on community living and shared responsibility. Admission to the program is via completion of a referral form. More detailed information and a referral pack are available by calling Birribi on

Aboriginal Healing Services Aboriginal Healing Services are community run residential rehabilitation services. The basis of the programs is to strengthen the existing skills and knowledge of the young people in the program and as an outcome assist them to remain drug free. The core of the design, processes and program are consistent with Indigenous cultural knowledge and practices. Koori Youth Healing Service is for Koori young people aged 15 – 20 yrs, 6 beds. Referral through Ngwala Willumbong or YSAS Baroona is a 4 bed facility in Echuca for year olds. Referral through Njernda Aboriginal Co-operative. Warrakoo – residential rehabiliation and life skills program for men. 100kms from Mildura, up to 12 clients at one time. Referral through Mildura Aboriginal Co-operative Baroona, a place to go and reconnect with their land and culture and create their own healing journey.

Rehabilitation and Post Withdrawal – Supported Accommodation Supported accommodation provides short term support in a safe, drug-free environment to clients who require assistance in controlling their alcohol and drug use. Provide support and assistance to enhance the clients capacity for non- drug using community living through skill acquisition, counseling, personal care activities and relapse prevention. Services for client groups with specific needs are; Women's drug & alcohol supported accommodation – who provide support to residents as well as their children Youth drug & alcohol supported accommodation – who provide more intensive support due to the age of participants (this can include their children)

Rehabilitation and Post Withdrawal – Peer Support Provides mutual support and information by individuals with a personal experience of alcohol and drug use. Peer support groups or activities are usually established by current or past alcohol and drug users. SHARC’s Recovery Support Services is a peer based community, assistance includes supported 12 step live in program.

The AOD Service System Counseling and Support Counselling, Consultancy & Continuing Care Peer Support Outreach NSP Day Programs Withdrawal Services Residential Withdrawal Home Based Withdrawal Hospital Rural Withdrawal Withdrawal – Public and Private Outpatient Withdrawal Rehabilitation and Post Withdrawal Residential Rehabilitation Supported Accommodation Peer Support Pharmacotherapies Opiates Nicotine Alcohol Information Services Telephone websites Client Group Specific Services AOD forensic services

Services for Specific Target Groups Young People YSAS Line Youth Outreach and Support - YSAS Residential Withdrawal – windana, moreland hall, YSAS Home based Withdrawal – community health, YSAS Youth Residential Rehabilitation – Birribi, Baroona, Healing Service Youth Supported Accommodation – Ways, Willum Outdoor Therapy for Young People – Toe program Families Family Drug Help ( ) Parent Support Groups - YSAS Family Counselling Programs ABCD Program Odyssey House Family Drug Help

Services for Specific Target Groups Females Chemical Dependency Unit (13 statewide) – outpatient services to women who are pregnant and have an identified chemical dependency. Westadd Women’s and Children support program Koori Sobering up / night patrol services Koori community AOD workers – local co-op or, Rondon Residential rehabilitation programs – Galiamble, Winja Ulupna Culturally Specific Programs Drug Specific TRANX Caution with Cannabis (Moreland hall)

The AOD Service System Counseling and Support Counselling, Consultancy & Continuing Care Peer Support Outreach NSP Day Programs Withdrawal Services Residential Withdrawal Home Based Withdrawal Hospital Rural Withdrawal Withdrawal – Public and Private Outpatient Withdrawal Rehabilitation and Post Withdrawal Residential Rehabilitation Supported Accommodation Peer Support Pharmacotherapies Opiates Nicotine Alcohol Information Services Telephone websites Client Group Specific Services AOD forensic services

Forensic Services Community Offenders Advice and Treatment Service (COATS) The Intensive Post Prison Release Drug Treatment Service (Stepout) The Drug Education for First Offenders Service (FOCiS) Court Referral Evaluation and Drug Intervention Treatment (CREDIT) Drug Diversion Program