 You are working in a children’s ward in a country hospital. Toni is a 15 yr old girl who lives with her mother and two younger sisters  She has a reputation in the community for fighting and stealing, using lots of drugs and alcohol and has been suspended from school  One day she steals your neighbours purse and the old lady she robbed is admitted to hospital in shock  The next day Toni is admitted with abdominal pain, she tells you that she didn’t mean to hurt the lady but she was ‘out of it’ on ‘ice’ Youth/Rural Case Study (1) Outline (from C. Capus, Adolescent Justice Health)

1.How would you assess Toni’s drug and alcohol use? 2.Which drugs would you be most concerned about? 3.How would you feel about nursing Toni? 4.What follow up would you organise for her? 5.How would you access information or advice about this situation? Youth/rural Case Study (2) Questions – in small or large group(s)

1.Ask for adult assessment, but also ask about Toni’s safety, whether she uses alone or with others (i.e. do they share their drugs or alcohol – this may affect how much she is using). Make the conversations informal, be honest with her, ask if there is peer or family pressure to use, ask about club drugs, steroids and solvents. Discuss harms relating to overdose, driving and poly drug use 2.Alcohol and ice – but you should ask Toni about all other drug use during the assessment 3.Ask participants or refer to the activities in ‘Why people use Drugs’ presentation. There may be confidentiality issues if you know the neighbour, Toni and/or her parents. There may be conflicts in interest in nursing Toni. Youth/rural Case Study (3) Brief guide to answers for the questions

4. Possible referral to local youth D&A services in area (if available), or youth health services. Use opportunistic intervention to explore Toni’s drug use and to give information re risky use, effects of drugs etc. Give Toni relevant phone numbers – e.g. youth help line, D&A services 5. Local Drug & Alcohol Services and refer to NSW Drug and Alcohol Withdrawal Clinical Practice Guidelines NSW Health Alcohol Drug and Information Service , & NSW D&A Specialist Advisory Service (DASAS) hr Youth/rural Case Study (4) Brief guide to answers for the questions