Transcript Home based withdrawal services

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
Information Services
Telephone
websites
Counseling and Support
Withdrawal Services
Residential Withdrawal
Home Based Withdrawal
Hospital
Rural Withdrawal
Counselling, Consultancy &
Continuing Care
Withdrawal – Public and
Private
Peer Support
Outpatient Withdrawal
Outreach
Pharmacotherapies
NSP
Opiates
Day Programs
Nicotine
Alcohol
Client Group Specific Services
AOD forensic services
Rehabilitation and
Post Withdrawal
Residential
Rehabilitation
Supported
Accommodation
Peer Support
The AOD Service System
Information Services
Telephone
websites
Counseling and Support
Withdrawal Services
Residential Withdrawal
Home Based Withdrawal
Hospital
Rural Withdrawal
Counselling, Consultancy &
Continuing Care
Withdrawal – Public and
Private
Peer Support
Outpatient Withdrawal
Outreach
Pharmacotherapies
NSP
Opiates
Day Programs
Nicotine
Alcohol
Client Group Specific Services
AOD forensic services
Rehabilitation and
Post Withdrawal
Residential
Rehabilitation
Supported
Accommodation
Peer Support
Information Services
Telephone
Direct line 9416 1818 or 1300 136 385 (24 hour service
for counseling, information and referral services)
Poisons Information Line
YSAS Line 1800 014 446
24 hour information, counseling and referral to
YSAS and other youth specific services throughout Victoria.
DACAS
9416 3611 or 1800 812 804 (24 hour advice on clinical management
of drug and alcohol issues) usually used by health professionals
Drug Info
13 15 70 (24 hour info services about drugs and alcohol)
Websites
Better Health Channel www.betterhealth.vic.gov.au (Directories will give you
contacts for various agencies)
Drug Info Clearing House
www.druginfo.adf.org.au/
Australian Drug Foundation www.adf.org.au/
Information and resources
Australian Drug Information Network (part of ADF) www.adin.com.au/
information, services and resources (including information in other languages)
The AOD Service System
Information Services
Telephone
websites
Counseling and Support
Withdrawal Services
Residential Withdrawal
Home Based Withdrawal
Hospital
Rural Withdrawal
Counselling, Consultancy &
Continuing Care
Withdrawal – Public and
Private
Peer Support
Outpatient Withdrawal
Outreach
Pharmacotherapies
NSP
Opiates
Day Programs
Nicotine
Alcohol
Client Group Specific Services
AOD forensic services
Rehabilitation and
Post Withdrawal
Residential
Rehabilitation
Supported
Accommodation
Peer Support
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 Anonymous
www.alcoholicsanonymous.org.au
Narcotics Anonymous
www.naoz.org.au
Women for sobriety
9836 7455
Self Held Addiction Resource Centre (SHARC)
Phone: 03 9573 1700 http://sharc.org.au/
Family and Friends Support Group
Voice / land line 9386 2876
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;
Anex
Phone: (61 3) 9486 6399
Email: [email protected]
Web: Anex (the Association for Prevention and Harm Reduction Programs)
Vivaids
Phone: (61 3) 9329 1500
Email: [email protected]
Web: VIVAIDS Victorian Drug User Group
Hep C council of Victoria
Phone: 1800 703 003
Web: http://www.hepcvic.org.au/
Victorian Aids Council
Phone: (61 3) 9865 6700
Email: [email protected]
Web: http://www.vicaids.asn.au/content/default.asp
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 14-21 years who may be either
linked or involved in treatment with the alcohol and drug treatment
sector.
12-14 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
Information Services
Telephone
websites
Withdrawal Services
Residential Withdrawal
Home Based Withdrawal
Hospital
Counseling and Support
Counselling, Consultancy &
Continuing Care
Peer Support
Outreach
NSP
Day Programs
Rural Withdrawal
Withdrawal – Public and
Private
Outpatient Withdrawal
Pharmacotherapies
Opiates
Nicotine
Alcohol
Client Group Specific Services
AOD forensic services
Rehabilitation and
Post Withdrawal
Residential
Rehabilitation
Supported
Accommodation
Peer Support
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) 8345 6682
Windana Society
88 Alma Road, ST KILDA EAST 3183,
Phone: (03) 9529 7955
Uniting Care Moreland Hall
26 Jessie St, Coburg 3058,
Phone: (03) 9386 2876
South East Alcohol & Drug Services
(SEADS)
Drug Withdrawal Unit
229 Thomas Street DANDENONG 3175
Phone: (03) 8792 2330
DePaul St Vincent's Hospital
Community Residential Drug & Alcohol
Withdrawal Unit
38 Fitzroy Street, FITZROY 3065
Phone: (03) 9288 2624
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) 9889 4255
Windana Youth Community House (WYCH)
39A Clow Street, Dandenong
Phone: (03) 9793 2155
YSAS Fitzroy Residential Withdrawal Unit
Gertrude Street Fitzroy
Phone: (03) 9415 9996
DASWest
3-7 Eleanor Street, FOOTSCRAY 3011
Phone: (03) 8345 6682
YSAS Geelong Residential Withdrawal Unit
Geelong
Phone: (03) 5248 4777
Uniting Care Moreland Hall
26 Jessie Street, Moreland
Phone: (03) 9386 2876
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.
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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) 9521 2770
South East Alcohol & Drug Services
Home-Based Withdrawal Programs
Address: Level 2, 229 Thomas Street
DANDENONG
Phone: (03) 8792 2330
Alcohol & Drug Program
Drug Withdrawal Team
228 Pakington Street
GEELONG WEST
Phone: (03) 5222 1700
Uniting Care Moreland Hall
Home-Based Withdrawal Program
Address: 26 Jessie Street MORELAND
Phone: (03) 9386 2876
Barwon South West Youth Alliance
12-14 Halstead Place
GEELONG WEST
Phone: (03) 5244 7372
Western Region Alcohol & Drug Centre
Youth Home-Based Withdrawal
Address: 26 Fairy Street WARRNAMBOOL
Phone: (03) 5560 3222
DasWest, Home-Based Withdrawal Service
Western Hospital
3-7 Eleanor Street FOOTSCRAY
Phone: (03) 8345 6682
YSAS
Home-Based Withdrawal Support Service
Women & Children's Drug & Alcohol Service
Home-Based Drug Withdrawal Service
129 Durham Road SUNSHINE
Phone: (03) 9311 3099
Peninsula Drug & Alcohol Program
Outpatient & Home Withdrawal Service
Hastings Road FRANKSTON
Phone: (03) 9784 8100
Access Alcohol & Other Drug Services
Home-Based & Outpatient Drug Withdrawal
Address: 1st Floor, Upton House,
Thames Street BOX HILL
Phone: (03) 9895 3348
BOX HILL
Phone: (03) 9890 7855
FRANKSTON
Phone: (03) 9770 5622
DANDENONG
Phone: (03) 9701 3488
BENDIGO
Phone: (03) 5444 2969
CITY NORTH WEST
Phone: (03) 9415 8860
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: 59-547- 522
Pinelodge Clinic
1480 Heatherton Road Dandenong Phone : 9794- 5953
Epworth Hospital - Drug And Alcohol Unit
34 Erin Street Richmond Phone: 9426-6331
Vaucluse Hospital 82 Moreland Road Brunswick Phone: 9383-1155
The AOD Service System
Information Services
Telephone
websites
Counseling and Support
Withdrawal Services
Residential Withdrawal
Home Based Withdrawal
Hospital
Rural Withdrawal
Counselling, Consultancy &
Continuing Care
Withdrawal – Public and
Private
Peer Support
Outpatient Withdrawal
Outreach
Pharmacotherapies
NSP
Opiates
Day Programs
Nicotine
Alcohol
Client Group Specific Services
AOD forensic services
Rehabilitation and
Post Withdrawal
Residential
Rehabilitation
Supported
Accommodation
Peer Support
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
Information Services
Telephone
websites
Counseling and Support
Withdrawal Services
Residential Withdrawal
Home Based Withdrawal
Hospital
Rural Withdrawal
Counselling, Consultancy &
Continuing Care
Withdrawal – Public and
Private
Peer Support
Outpatient Withdrawal
Outreach
Pharmacotherapies
NSP
Opiates
Day Programs
Nicotine
Alcohol
Client Group Specific Services
AOD forensic services
Rehabilitation and
Post Withdrawal
Residential
Rehabilitation
Supported
Accommodation
Peer Support
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 9430 2300.
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.
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Koori Youth Healing Service is for Koori young people aged 15 – 20 yrs, 6 beds.
Referral through Ngwala Willumbong or YSAS
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Baroona is a 4 bed facility in Echuca for 14-24 year olds.
Referral through Njernda Aboriginal Co-operative.
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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 nondrug 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
Information Services
Telephone
websites
Counseling and Support
Withdrawal Services
Residential Withdrawal
Home Based Withdrawal
Hospital
Rural Withdrawal
Counselling, Consultancy &
Continuing Care
Withdrawal – Public and
Private
Peer Support
Outpatient Withdrawal
Outreach
Pharmacotherapies
NSP
Opiates
Day Programs
Nicotine
Alcohol
Client Group Specific Services
AOD forensic services
Rehabilitation and
Post Withdrawal
Residential
Rehabilitation
Supported
Accommodation
Peer Support
Services for Specific Target Groups
Young People
YSAS Line 1800-014-446
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 (1800-888-236)
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 9510 3233
Residential rehabilitation programs – Galiamble, Winja Ulupna
Culturally Specific Programs
Drug Specific
TRANX
Caution with Cannabis (Moreland hall)
The AOD Service System
Information Services
Telephone
websites
Counseling and Support
Withdrawal Services
Residential Withdrawal
Home Based Withdrawal
Hospital
Rural Withdrawal
Counselling, Consultancy &
Continuing Care
Withdrawal – Public and
Private
Peer Support
Outpatient Withdrawal
Outreach
Pharmacotherapies
NSP
Opiates
Day Programs
Nicotine
Alcohol
Client Group Specific Services
AOD forensic services
Rehabilitation and
Post Withdrawal
Residential
Rehabilitation
Supported
Accommodation
Peer Support
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