Supporting People with Alcohol and Drug Problems: Making a Difference

298 Pages·2012·3.4 MB·English

by  Sarah Galvani

Supporting people
with alcohol and
drug problems
Making a difference
SARAH GALVANI

SOCIAL WORK IN PRACTICE series
Supporting
people with
alcohol and drug
problems
Making a difference
Sarah Galvani
First published in Great Britain in 2012 by
The Policy Press
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ISBN 978 1 84742 116 6 paperback
ISBN 978 1 84742 117 3 hardcover
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Social Work in Practice series
Series editors: Viviene Cree, University of edinburgh and
Steve Myers, University of Salford
“This series combines all the elements needed for a sound basis in 21st-
century UK social work. Readers will gain a leading edge on the critical
features of contemporary practice. It provides thoughtful and challenging
reading for all, whether beginning students or experienced practitioners.”
Jan Fook, Professor in Social Work Studies, University of Southampton
this important series sets new standards in introducing social workers to
the ideas, values and knowledge base necessary for professional practice.
these core texts are designed for students undertaking professional
training at all levels as well as fulfilling the needs of qualified staff seeking
to update their skills or move into new areas of practice.
Editorial advisory board:
Karen Bowler, the Policy Press
Suzy Braye, University of Sussex
Jim Campbell, Goldsmith’s University of london
Gina Hardesty, independent consultant
Sue Hatton, BaSW
Ravi Kohli, University of Bedfordshire
Jill Manthorpe, king’s college london
Kate Morris, University of Birmingham
Joan Orme, University of Glasgow
Alison Shaw, the Policy Press
Charlotte Williams, keele University
Other titles in the series:
Social work: Making a difference by Viviene cree and Steve Myers
Social work and multi-agency working: Making a difference
edited by kate Morris
Youth justice in practice: Making a difference by Bill Whyte
Radical social work in practice: Making a difference by iain Ferguson
and rona Woodward
Religion, belief and social work: Making a difference by Sheila Furness
and Philip Gilligan
Communicating with children and young people: Making a difference by
Michelle lefevre
Social work and lesbian, gay, bisexual and trans people: Making a difference
by Julie Fish

Contents
list of tables, figures and boxes vi
acknowledgements viii
list of abbreviations ix
one Setting the scene: alcohol and drugs in social work practice 1
two Working with people using substances 13
three Working with specialist substance use services 37
four Substance use among black and minority ethnic people 59
five Substance use and parenting 85
six Domestic abuse and substance use 111
seven older people’s substance use 135
eight Young people’s substance use 159
nine coexisting mental distress and substance use 181
ten Mind the gap: people with disabilities and substance use 209
eleven conclusion 241
references 245
index 279

v
List of tables, figures and
boxes
Tables
3.1 tiers of service 45
4.1 Summary of the needs of ethnic minority groups, based on 72
five Fountain (2009a, b, c, d, e) studies
5.1 Protective and resilience factors 102
8.1 the law relating to young people’s alcohol consumption 165
10.1 Possible risk and protective factors for substance use 218
Figures
2.1 the Six cornered addiction rescue System (ScarS) 33
7.1 aUDit c 151
7.2 Short MaSt-G 151
9.1 Hopscotch Model of Dual recovery (Davidson et al 2008) 203
Boxes
1.1 alcohol units (nHS choices 2011) 3
1.2 classification of drugs 4
1.3 code of Practice 10
2.1 alcohol and drugs information websites 18
2.2 Ways of using substances 19
2.3 Before you start 21
2.4 Pre-assessment considerations 23
2.5 relapse and lapse 28
3.1 the new ‘recovery’ agenda 41
3.2 terminology 43
3.3 Detoxification 55
4.1 Mental health and substance use among minority ethnic 66
groups
5.1 information on FaSD/naS 98
5.2 Pregnancy, domestic violence and substance use 99
6.1 the Stella Project toolkit 128
vi
liSt oF taBleS, FiGUreS anD BoXeS
6.2 respect 131
7.1 When do you reach ‘older’ age? 136
7.2 Units of alcohol and older people 138
8.1 Who counts as a young person? 160
8.2 Smoking among 11- to 15-year-olds 162
8.3 the impact of advertising on young people 164
8.4 Substitute prescribing 175
8.5 Young people’s sources of information on substances 177
9.1 Diagnostic criteria for substance use 184
9.2 the cannabis debate 187
9.3 code of Practice – Mental Health act (MHa) 1983 191
(amended 2007)
9.4 assessment of intoxicated people 199
10.1 Definition of disability 210
10.2 terminology – learning difficulties and learning disabilities 214
10.3 keeping language clear 226
10.4 Good practice – people with traumatic Brain injury (tBi) 237
and substance problems

vii
Acknowledgements
A number of social work friends and colleagues have contributed to the
production of this book. Their advice and experience has been invaluable.
These people include: Trevor McCarthy, Kate Holliday, Rachel Hek, Pete
Hoey, Melody Treasure, Isfharn Khan, Jo Utting, Nicki Walker, Richard
McVey, Linda Sole, Russell Norton.
Thanks go to Larry Harrison and Dr Katy Cigno – friends and former
lecturers who encouraged my confidence, passion and interest in substance
use issues.
I very much appreciate all the social workers and students who have
emailed their interest in, and support for, this book and all those who
responded to my requests for advice or help via the jiscmail list on social
work–alcohol–drugs. I was only able to follow up some of the offers but they
were all greatly appreciated. Particular thanks to regular responders including
Jane Elliot, Lynne Froud, Dan Caruana, Alan Laurie, Gwen Moncrieff.
A number of specialist alcohol and drug agencies have also been very
supportive of their staff contributing to this book. Those who have given
their permission include Dash NHS North West, Project 6 Drug and Alcohol
Agency, Aquarius, Angus Council Social Work & Health, Harbour Drug &
Alcohol Services.
Finally, my love and thanks go to my parents for their unconditional
support and, most of all, to my partner for his endless patience, love and
support.

viii
List of abbreviations
aa alcoholics anonymous
aDHD attention Deficit/Hyperactivity Disorder
aMHP approved Mental Health Professional
BaSW British association of Social Work
Bi Brief interventions
BMi Brief Motivational intervention
caF common assessment Framework
cBt cognitive Behavioural therapy
ccetSW central council for education and training in Social Work
cM contingency Management
cnS central nervous System
cra community reinforcement approach
cSiP care Services improvement Partnership
Daat Drug and alcohol action team
DcSF Department for children, Schools and Families
Dfe Department for education
Dfee Department for education and employment
DfeS Department for education and Schools
DH Department of Health
DSM-iV Diagnostic and Statistical Manual of Mental Disorders, 4th
edition (aPa 2000)
eMcDDa european Monitoring centre for Drugs and Drug addiction
FaSD Foetal alcohol Spectrum Disorder
GScc General Social care council
iaS institute of alcohol Studies
Met Motivational enhancement therapy
Mi Motivational interviewing
na/ca narcotics/cocaine anonymous
naS neonatal abstinence Syndrome
natMS national alcohol treatment Monitoring System
nDtMS national Drug treatment Monitoring System
niaaa national institute on alcohol abuse and alcoholism
nice national institute for Health and clinical excellence
niMHe national institute for Mental Health (england)
noS national occupational Standards
nta national treatment agency for Substance Misuse
onS office for national Statistics
ScarS Six cornered addiction rescue System
Scr Serious case review
SDS Severity of Dependence Scale
ix