Relapse prevention clinic

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1 Relapse prevention clinic Doncaster drug and alcohol services RDaSH Substance Misuse Services

2 Relapse Prevention Clinic Sinclair House Thorne Road Doncaster DN1 2EZ Tel: Treatment, support and monitoring for those with alcohol dependency. 2 Relapse prevention clinic

3 Once you have been assessed you will be allocated a key worker, and together you will formulate a care plan. This is an agreement between you and the treatment service on a plan of action. Your preferences for treatment are important. When agreeing a plan of care, staff will talk to you about various options. The prescribed treatments that are available to help you with your alcohol problem are to support you in achieving abstinence (to help you stop drinking alcohol altogether). There is a range of treatment available, which your keyworker and doctor will discuss with you before you start: Acamprosate This is a medication used to help reduce your cravings for alcohol. It does not cause a reaction if alcohol is consumed while taking it, but if you do drink alcohol the medication won t be effective. How does acamprosate work? The exact mechanism of acamprosate is unknown, but it is thought that acamprosate works on the neurons in the brain to reduce the cravings and desire for alcohol. What is the dosage of acamprosate? Acamprosate is usually prescribed as two tablets three times a day. The dose you are prescribed will be decided by the doctor and may vary slightly, depending on other factors such as your body weight. What are the side effects? Common side effects associated with acamprosate are diarrhoea, nausea, vomiting, abdominal pain and changes in libido. These side effects usually resolve after a couple of weeks of taking acamprosate. Should you experience any side effects related to acamprosate, you can discuss this with the nurse at clinic or your key worker. Naltrexone Naltrexone is an opioid antagonist that interferes with the part of the brain involved in producing the pleasure you get from drinking alcohol. It reduces the pleasurable effects of alcohol. What is the dosage of Naltrexone? The usual dose is 25mg per day initially, aiming for a maintenance dose of 50mg per day. 3

4 What are the side effects if Naltrexone. Naltrexone can cause nausea, dizziness and fatigue. It also can cause headaches and make you feel anxious, sleepy, or nervous. Should you experience any side effects related to Naltrexone you can discuss this with the nurse at clinic or your key worker. Antabuse. Antabuse is used as a support agent to deter you from drinking alcohol. You will experience a series of unpleasant reactions when taken with alcohol, which may dissuade you from consuming more alcohol. How does antabuse work? Antabuse is an alcohol deterrent and is used as a supportive agent in the treatment of drinking problems. When you drink alcohol it is metabolised in the body to acetaldehyde. Antabuse blocks the enzyme which breaks down acetaldehyde. This leads to an increased level of acetaldehyde in the blood provoking a series of unpleasant physical reactions. What is the medicine used for? Antabuse is used to deter people from drinking alcohol. It is prescribed in the treatment of people with drinking problems. If you are treated with antabuse and drink alcohol you will experience a series of unpleasant physical reactions. These include headache, flushing, rash, nausea, vomiting and irregular heart beat. The reaction may be sufficiently unpleasant to stop you from consuming further alcohol. Antabuse stays in your system for a period of five to seven days. It is therefore advised that you do not consume alcohol during this time. Before starting antabuse you will be asked to sign a consent form regarding the effects of the medication if taken with alcohol and that you understand the risks associated with antabuse. Which food/ medicines should I avoid? Some foods cooked with alcohol, cough medicines, toiletries, perfumes, deodorants, hair dyes and sprays contain alcohol. Further advice will be given at the clinic. What is the dosage of antabuse? 4 Relapse prevention clinic

5 The usual dosage of antabuse is 400mg three times a week or 200mg every day. The dose you are prescribed will be decided by the doctor or prescriber and may vary slightly depending on other factors such as your blood test results. What are the side effects? Usual side effects associated with antabuse are drowsiness and tiredness, but these side effects usually resolve after a couple of weeks of taking antabuse. Other side effects include nausea, vomiting and bad breath. Should you experience any side effects related to antabuse you can discuss this with the nurse at clinic or your key worker. Monitoring of antabuse. If you start taking antabuse you will be required to have regular blood tests at two, six and 12 weeks of being on treatment. Caution: Some non-alcoholic beers and wines still contain a small percentage of alcohol therefore we recommend that you avoid drinking these. How long will I require medication? It is recommended that medication is prescribed for a period of six to 12 months and that you engage with other psychosocial interventions (e.g. groups, AA, counselling) during the time that you are on your medication. Evidence suggests that this is the most successful combination in helping you achieve recovery. Pregnancy. Women who suspect they are pregnant or are contemplating becoming pregnant are advised to consult with the nurse in the clinic. Clinic. The clinic is a drop-in service on a Monday, Wednesday and Friday at Sinclair house between 10am and 12pm. Aims of the clinic: 1. It allows you the opportunity to collect your treatment 2. To assist and encourage you to address your dependency on alcohol 3. To offer you a high level of support and to monitor your physical and psychological wellbeing while on treatment. 4. To encourage compliance with 5

6 your individual treatment plan. 5. To assist and encourage you to use other coping strategies that are non-alcohol related. What happens at the clinic? 1. On attendance at the clinic you will be asked to use an alcometer which measures if there is any alcohol present in the body. If negative, you will be given your treatment. 2. You can also attend the clinic to discuss any problems or issues you may be having. How often do I need to attend clinic? Your attendance at the clinic will vary on the treatment you are on: 1. Acamprosate- once a month 2. Naltrexone- once a month 3. Antabuse- you will attend the clinic three times a week (unless previously agreed with the doctor or nurse) for a period of six weeks, then you will be required to attend once a month. Commitment. If you fail to attend the clinic this may result in your discharge. You are asked to fully co-operate with the running of the clinic as outlined in this leaflet. Contact Doncaster drug and alcohol services team if you are unable to attend the clinic. Honesty is expected at all times. If you have consumed alcohol at any time you must inform the clinic staff. Bank Holidays Please note- the clinic will be closed on Bank Holidays. Useful telephone numbers. Doncaster Drug and Alcohol Services Doncaster Royal Infirmary AA Helpline You will be reviewed every three months by a doctor or prescriber. 6 Relapse prevention clinic

7 Clinic Times The Relapse Prevention Clinic runs from: am to pm Monday Wednesday Friday Key A CAT Premises Christ Church 7

8 This information is correct at the time of publishing Last Reviewed: June 2013 get approved We are a smokefree organisation WZT698/DP5899/10786/06.13

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