1. Mental Health and Drug Awareness, Legislation and Assessment

2. Objectives for today and tomorrow: Gain a deeper understanding of the Health and Social Care system Begin to understand where care services come from Look at acronyms and jargon and start to understand it more Get a start to understanding the MHA Look at mental health and disorder Look at Drug use Look at assessment and planning Your paperwork

3. The Health and Social Care set up, Acronyms and jargon.

4. Mental Health Law (MHA) Parts Sections Rights Expectations

5. Exercise What do you know about the MHA? Lets brainstorm all we know. What experience have you had of mental health law?

6. Mental Health disorder and health

7. Drug and Alcohol

8. SOME TERMS Psychoactive drug... those that alter mood, cognition or behaviour. Dependence.... a condition in which a drug produces a feeling of satisfaction and a drive that requires periodic or continuous administration of the drug to produce pleasure or reduce discomfort. Physical dependence.... an adaptive state that manifests itself by intensive physical disturbance when the administration of a drug is suspended.. Neuroadaptation …. refers to the neuronal changes associated with physical dependence & tolerance Tolerance... as a result of repeated dosing with a drug increasingly higher doses are required to achieve the same effect.

9. DRUG, SET & SETTING Drug The properties of the drug itself Set The psychological set of the individual Setting The environment (physical, cultural and social) in which the drug is taken The interaction of these three variables influence the individuals experience of drug use. This can be used to explain why some people develop problems and others don't. Changing any of the three variables will influence the users experience. Treatment of drug users can be targeted at any or all of the three variables.

10. What and how? Heroin, Morphine, Codeine, Methadone, Many pharmaceuticals Inhalation, smoking, Intravenous injection, Intramuscular injection, oral, tablets crushed How Much? Anything from £5 to £50 daily. More is often used when smoking and inhalation than IVI. Any number of tablets taken Good things reported Euphoria, sleep induction, Energy, Blocking out, relaxation, warmth, analgesia, emotional numbness, drowsy, reduced ability to cough, rush intensified if injected IV Less good things reported Nausea, Respiratory depression, itching, vomiting, odd taste, constipation Some withdrawal problems Muscular aches, Diarrhoea, Yawning, Sweating when cold, nausea and vomiting, piloerection, stomach cramps, runny nose/eyes, sneezing, irritability, Low mood, cramps, watery eyes, ejaculation, dilated pupils, increased risk of choking Opiates and Opioids

11. Cannabis Cannabis is a sedative and hallucinogenic drug produced from the leaves and buds of the cannabis sativa plant. Most commonly used illegal drug. Cannabis is an illegal substance under class B of the misuse of Drugs Act. dried leaves or black/brown block of resin Cannabis leaves or resin are smoked (roll-up with tobacco or in a bong) Signs of Use: reddened eyes, dilated pupils, increased pulse rate, drowsiness, giggling, and a sweet herbal smell. Effects: relaxation, increased senses, slowing of thoughts, time seems to pass more slowly, sometimes mild hallucinogenic effects. Risks: mouth and lung cancer, exacerbate other lung conditions, increases likelihood of psychosis, road traffic accidents whilst driving under the influence.

12. Medical treatment options Substitutes with aim to reduce Substitutes with aim to maintenance Substitutes for detoxification Alternative prescribing with aim to detoxification Maintenance

13. Reasons for use To feel euphoric or feel nothing To feel more confident To work longer hours or enhance performance To belong to a social group (peer pressure) To kill time (alleviate boredom) To alleviate physical pain and other health problems Because it is a habit To satisfy cravings and avoid withdrawal symptoms For weight loss To experience an altered state of consciousness To unwind after a stressful day

14. Assessment

15. Assessment of drug/alcohol problems Model of change What is it? Why use it? How useful is it really? Start to think about motivation!!!!

16. Model of Change or The Transtheroetical Model of Change Developed by Prochaska and Di Clemente Motivation and resistance Comprises Stages, levels and process Concentrate today on stages and levels

17. Stages of Change. Pre-contemplation Contemplation Determination Action Maintenance Relapse

18. Drug/Substance Assessment? The start of therapy Listening Usually the first session Initial meeting Information gathering process General overview of issues Specific identification of issues Sequence of events Information/advice giving “Getting to know you” Problem identification Who’s problem is it?

19. What are we looking for? Typical day Heavy and light days Narrowing of repertoire Salience of drug use Tolerance Withdrawal symptoms Relief use Previous relapse cues

20. Step 5 - Encourage self-help strategies for you too!! Keep physically active Eat well Alcohol in moderation Value yourself Talk about your feelings Keep in touch Care for others Get involved/learn new skills Do something creative Take a break Ask for help 30