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Models of care for treatment of adult drug misusers: Update 2006

Tier 1 interventions

Definition

Tier 1 interventions include provision of drug-related information and advice, screening and referral to specialised drug treatment.

Interventions

Commissioners need to ensure that a range of generic services provide, as a minimum, the following Tier 1 drug interventions:

  • Drug treatment screening and assessment

  • Referral to specialised drug treatment

  • Drug advice and information

  • Partnership or “shared care” working with specialised drug treatment services, to provide specific drug treatment interventions for drug misusers within the context of their generic services. Specific drug treatment liaison schemes may need to be commissioned to fully realise partnership work.

Generic services should also provide their own services to drug misusers and some may be specifically designed for drug misusers (e.g. housing projects for those leaving rehabilitation). Commissioners should ensure that drug misusers are not marginalised from generic services by developing local strategic partnerships.

Settings

Tier 1 interventions are provided in the context of general healthcare settings (e.g. liver units, antenatal wards, Accident and Emergency and pharmacies), or social care, education or criminal justice settings (probation, courts,

prison reception) where the main focus is not drug treatment.

Competency

Staff require competence to screen and identify drug misuse and refer into local specialised drug treatment systems, in accordance with local protocols, to provide drug-related advice and information and to work in partnership with specialist drug treatment services.

Commissioners may need to ensure competency-based training, information on local systems and drug liaison

workers to support partnership projects.

Of particular relevance are DANOS39 Standards (Drug and Alcohol National Occupational Standards): AA1 “Recognise indication of substance misuse and refer to specialists”; AB2 “Support individuals who are substance misusers”; AB5 “Assess and act on risk of danger to substance misusers”, and AF1 “Carry out screening and referral assessment”.

Tier 1 interventions: Drug-related information and advice, screening and referral by generic services

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