Substance misuse service Contents Supporting you in your recovery Page 3 Working together towards recovery Page 4 Assessment Page 4 Developing a treatment plan Page 5 Treatment options alcohol Page 6 Treatment options opiates Page 7 Our Community Teams Page 9 Newcastle and Moorlands Page 9 Stoke Page 10 Edward Myers Unit (EMU) Page 11 How to get referred to EMU Page 13 Health promotion Page 13 PALS & Complaints Team Page 14 Talk to Frank Page 15 How to contact our services Page 16 Supporting you in your recovery - a guide to our services Interpretation Services If English is not your first language or you use sign language and you require an interpreter please let us know and we will arrange this for your assessment. Available in other formats The information in this booklet can be made available to you in another language, large print version, in Braille or in audio format, contact PALS on 0800 389 9676.
Supporting you in your recovery North Staffordshire Combined Healthcare NHS Trust provides services in the local community and in hospital for people wishing to recover from misuse of alcohol and/or drugs. This booklet tells you about what we do and how you can be referred to us. It also tells you about other local services that we work in partnership with to help you. Our approach to your care includes the recovery model, which means we believe that when people are misusing drugs or alcohol significant improvements in physical and mental health are possible, and we want to help people achieve this. Understanding your life and experiences, past and present, is an essential part of recovery and well-being. This includes the difficult life experiences that can lead to stress and trauma, such as assault, domestic violence, debt, abuse, and neglect. Understanding your cultural and religious or spiritual beliefs is also very important. Our substance misuse services are there to support you in this process and can help you on the pathway to a full recovery. The life-style choices that will help you improve your health include exercise, good diet and sleep habits, outdoor, creative and social activities. We can identify what treatments may be helpful and either provide this ourselves or help you get access to them. This may include medication, counselling, social support or complementary therapy. Working together towards recovery Combined Healthcare NHS Trust has substance misuse teams throughout North Staffordshire that work together to help you. The next few pages explain how the services work with you and other health professionals towards your recovery. Assessment Your first assessment will be carried out by a nurse or doctor. It will take place in a range of locations such as your GP s surgery, your home or a clinic. The assessment will help us to identify what your needs are and which service would be the best to help you. At the assessment, we will focus on your alcohol or substance misuse difficulty. the assessment, but you need to consider that some sensitive areas may be discussed. The assessment involves gathering relevant information to get a clear picture. You will need to be as honest as possible when answering questions and talking about yourself to ensure that we have accurate information and can offer treatment that meets your needs. Your assessment should take about an hour. Please note that we may not be able to assess you if you are heavily intoxicated. 2 3
Developing a treatment plan Alcohol dependency Following assessment, the information gathered from you will be discussed by the team and the most suitable treatment will be agreed. This may mean continuing treatment with our service or you may decide that you would like to be referred to other services. Please feel free to ask any questions at anytime if you do not fully understand the process. You may find it useful to jot down any questions before the assessment appointment. Written information will be given to you, including a copy of your care plan once it has been agreed. Your GP will be informed about the assessment and care plan. We will provide further information if you choose to get support from another organisation. Options for treatment of alcohol misuse include: Planned and safe gradual reduction of alcohol to either safer levels or abstinence dependent on the individual. If suitable, home detoxification by a Community Mental Health Nurse (CMHN) with prescribed medication normally from your GP. If necessary, referral for inpatient detoxification. Blood tests may be arranged at your assessment to find out if your drinking has caused any physical health problems. Should this be the case, if you consent, you may be referred to a specialist for further help. If significant mental health problems are discovered, then you could either be referred to your GP for treatment or to a Psychiatrist for further assessment with your consent. You will be encouraged to consider referral to a Rehabilitation centre. Referral to other agencies for support, including Social Services, AA and ADSIS. During this process, your keyworker will work with you to reduce risk of relapse and help you to find ways of maintaining your abstinence. If your goal is a planned and safe, gradual reduction of alcohol drinking to reduce to a safe level (14 units per week for women, 21 units per week for men is recommended), you could be referred to ADSIS for support, or alternatively you may refer yourself. Helpline numbers and other details of organisations will be given to help you and your family/friends to seek support at any time. (see Page 13) The term opiate includes drugs such as heroin and prescribed painkillers such as codeine. 4 5
At your first appointment, you will have a full assessment including a urine screen or mouth swab test to find out what substances you are or have been taking. If required we prescribe medication to replace ( substitute ) the opiate drug you have been taking. The medications we use would be methadone or buprenorphine (also known as subutex). Depending on the outcome of the assessment you could then be accepted for treatment on one of the following options shown in the table, on the next page. Additional options for help will be discussed with you, this may include referral to Addaction or ADS. There is growing evidence to suggest that treatment supported by psychotherapy, such as Cognitive Behavioural Opiate Dependency Psychotherapy, may benefit some people, your keyworker can discuss this with you. There is also evidence to suggest that auricular acupuncture (small needles placed at points in your ear) helps with cravings and with relaxation, you may be referred for this following discussion with your keyworker. The table on the next page shows the ways in which we can help you with your opiate addiction and how services work together towards your recovery. Shared Care If your GP is part of this scheme, he/she will be able to prescribe your opiate substitute. You will be expected to see both the GP and keyworker at regular intervals and will be expected to provide saliva or urine samples as required. Aim To stabilise on prescription and to consider planned reduction of prescription longer term. GP with Special Interest Clinic (GPSI) A clinic run by a GP specialising in substance misuse and opiate substitute prescribing. You will be expected to see both the GP and keyworker at regular intervals and will be expected to provide saliva or urine samples as required. Aim To stabilise on prescription, reduce/cease using other substances. Planned reduction when you are ready. Once stable, you may be transferred to shared care if your GP provides it. You may be transferred to the specialist clinic if specialist needs arise. Specialist Clinic (Edward Myers Centre) A clinic overseen by a Consultant specialising in substance misuse and opiate substitute prescribing. You will be expected to attend weekly at first and to provide a urine sample as required. You may also be asked to provide blood and breathalyser samples. Pregnant drug users will also be referred to this clinic. Aim To stabilise on prescription and be monitored weekly for any further substance use. Depending on your progress, you may be transferred to the GPSI. Pregnancy will be monitored throughout until 6 months after the birth, working with the maternity service at UHNS. 6 7
We have two teams providing services in the communities of Newcastle and Staffordshire Moorlands, and an alcohol detoxification service in Stoke-on-Trent. Newcastle and Moorlands Community Addiction Teams Each team is made up of experienced Community Mental Health Nurses (CMHN) and other professionals. We work with people experiencing difficulties as a result of either alcohol or drug use. We use the word drug to refer to prescribed medication such as painkillers and diazepam as well as illicit substances such as heroin. We offer advice, information and support and can assist in the treatment if you wish to detoxify. Our Community Teams You can talk to us to help you clarify the severity of your alcohol or substance use - or you may already recognise that you have a problem and want help. When you have been referred to one of the teams, you will be given the opportunity to discuss your difficulties and plan a way forward. Our service is confidential and includes help and support for concerned relatives or friends. By referral to our service you will be given the opportunity to discuss your difficulties and plan a way forward, see page 5. We also would wish to provide help/support for concerned relatives or friends. To access this service you need to be referred by your GP, Probation Worker, Social Worker, Addaction, or other Health Professional. You may be seen in your GPs surgery or in one of the clinics run by the teams. The Staffordshire Moorlands Team hold clinics in Cheadle Hospital and GP Surgeries in Biddulph and Leek and can contact on the following phone number. Staffordshire Moorlands Team: 0300 123 1535 The Newcastle Team hold clinics in Morston House, Newcastle and can be contacted on the following phone number. Newcastle Team: 01782 624890
Harplands Hospital includes the Edward Myers Unit (EMU) which provides our inpatient service for drug and alcohol misuse and our specialist outpatient clinics. How to get referred to Edward Myers Unit The referral process for Edward Myers depends on where your GP practice is. For people registered with GP s in North Staffordshire you can be referred by your GP to the Community Addiction Services (see page 9) who will assess you and refer onto the Edward Myers Unit for either inpatient or outpatient services as required. For people registered with GP s in Stoke on Trent, you can get referred to the Edward Myers Unit via the community alcohol and drug services run by Adsis or CRI (see page 13) this service is only available for inpatient services offered by the Edward Edward Myers Unit Specialist Outpatient Clinics EMU outpatient clinics provide a structured approach to treatment for clients dependent on drugs or alcohol. You will see medical and nursing staff working together. In addition to the clinic at EMU, we provide: the Pregnant Drug Use (PDU) clinic run from the maternity unit at the University Hospital in conjunction with the antenatal and midwifery team; The Drug Rehabilitation Requirement (DRR) run from Hanley Probation at Broom Street) with the probation officers. Inpatient service A clear plan of care will be developed with you, involving your drug worker, community addiction nurse, or other professional, before you are placed on the ward waiting list or admitted to the ward. This will help you to know what is happening during your admission and be involved in the design of the follow-on discharge plan. Before admission you be may able to visit the ward to help you prepare. Through the early part of your admission the care team will see you to refine your plan to meet your needs. It will be discussed and agreed with you. You will have access to, and copies of, the care plans as appropriate. Named Nurse You will be allocated a named nurse who will be responsible for your care while in hospital. If necessary, named nurses will liaise with and involve others in your care. They provide a link named nurse will have regular contact with you to discuss any concerns which you might have. Supportive Group Work During your stay you will be expected to participate in a number of group sessions, aimed at helping you maintain abstinence once you are discharged. Each weekday the physiotherapy department provides an exercise session, either on the ward or in the physiotherapy department. It consists of gentle exercise and takes into consideration your physical ability. Ward nursing staff run two groups a day lasting an hour each. The aim is for you to develop relapse prevention and relaxation techniques to help you to maintain a drug/alcohol-free lifestyle after you are discharged. We also offer complementary therapies such as relaxation and auricular acupuncture. We offer education sessions, providing you with information on the effects of alcohol/ drug misuse. Outside agencies attend the ward regularly, giving you an idea of other services that are available.
Health promotion In addition to the treatment options, assessment carried out by your nurse will include discussion and advice on other health related issues such as: Healthy diet Smoking Sexual health Hepatitis. Testing for Hepatitis A, B and C can be arranged. If required, referral can be made by your keyworker to a specialist Gastroenterologist for further assessment and treatment. Hepatitis B vaccinations can also be arranged by your keyworker. Referral back to GP if general health needs arise. ADSIS 2 Hargreaves Road, Dyson Way, Stafford, ST18 0WN Telephone 08445617079 CRI Canal Side, 3 Canal Arm, Festival Park, Stoke on Trent, ST1 5UR Telephone: 01782 212800 Alcoholics Anonymous Trinity Exchange, March Street South, Stoke-on-Trent, ST1 1JF Tel: 01782 266366 The BAC O Connor Centre 35 Clayton Road Newcastle-under-Lyme ST5 3AF Tel: 01782 615590 Addaction Unit 7 Fellgate Court Froghall Newcastle Under Lyme We re here to help All our substance misuse services staff are expected to listen and respond to your questions, suggestions, comments and concerns. Talk to any of our staff and they will help you or introduce you to a colleague who can. Service User Group There is a Service User Group which takes place on a weekly basis at EMC which is available for all clients who have used Combined Healthcare Substance Misuse Services. There is a Carer Group Meeting which takes place every 2 weeks at EMC which is available for carers/relatives of service users who wish to access support. If you are not satisfied with How to contact our PALS & Complaints team PALS and Complaints team members will be happy to help you with a concern, a question, help with a problem or listen to your comments. If you have a complaint that you want investigated, our Complaints staff will take this up with you. PALS & Complaints literature should be available from our addiction service staff - please ask them for a copy. The PALS & Complaints freephone number is 0800 389 9676 or text07841 730 821. You will receive a response during office hours Contacts: Aquarius Balwant House Havelock Place, Stoke on Trent ST1 4PR Tel: 01782 283113 ST5 2UA Tel: 01782 637658 ADS 18 Martin Street Stafford ST16 2LG Telephone: 01785 270080 their response, or prefer to speak to someone independent of our substance misuse services, you can phone or text our PALS and Complaints team. 10 11
Talk to Frank Frank is a national phone helpline about drugs. Ring FRANK anytime and speak to a friendly adviser who's professionally trained to give you straight up, unbiased information about drugs. Remember it s totally confidential we won't ask for your name or repeat your conversation with others. Just call this number for free: 0800 77 66 00 "Don t feel embarrassed, we ve heard it all before. We re here to listen to you and help you with anything you want to talk about" Quote from a FRANK adviser. Talk to Frank website www.talktofrank.com This can help with your questions and concerns about substances. In addition to an A-Z of drugs information, you can use the site to email Frank. The reply will come from frank@talktofrank.com and the subject line won't have your question in it. If you're worried about someone reading your emails, you can always set up a special email account with someone like Yahoo, Hotmail or Lycos. FRANK will only ever reply to your email. You'll never receive an email you didn't ask for. Text FRANK anytime with a question about drugs and you ll soon get an answer you can trust. And remember, it s totally confidential. Text 82111 to ask FRANK your question. The cost of sending a text to FRANK is the same as a standard text message - which will depend on your network tariff. There is no charge for receiving text messages from FRANK. Supporting you in your recovery - How to contact our services Community Teams Staffordshire Moorlands team: Eaton House Buxton Road Leek ST13 6EG 0300 123 1535 ext 2035 Newcastle team: Silverdale Surgery Vale Pleasant Silverdale Newcastle ST5 6PS 01782 624890 Edward Myers Unit Harplands Hospital Hilton Road Harpfields Stoke-on-Trent ST4 6TH Out-patient clinics 01782 441713 Inpatient Unit 01782 441715 You can also speak to your GP, who can refer you to our services. www.patientopinion.org.uk/services/rly An independent site about your experiences of health services North Staffordshire Combined Healthcare NHS Trust, 2011 Working to improve the health and wellbeing of the local communities 14 15