Clinical update
Illicit drug use ISTOCKPHOTO
Essential facts The national crime survey 2012/13 found that around 2.7 million people in England and Wales had taken an illicit drug in the past year, with about one third taking a class A drug. More than a third of adults have taken an illicit drug in their lifetime. In April 2013, the commissioning of substance misuse treatment services was transferred to local authorities, supported by health and wellbeing boards.
Tackling Drug Use NICE local government briefing (May 2014): http://publications.nice.org. uk/tackling-drug-use-lgb18 Needle/syringe programmes NICE public health guidance (April 2014): http:// guidance.nice.org.uk/PH52
What’s new In May, the National Institute for Health and Care Excellence (NICE) produced a local government briefing, Tackling Drug Use. Recommendations include more testing and treatment for blood-borne viruses among drug users, providing clean injecting equipment and other harm-reduction services through needle and syringe programmes, support for those who are trying to stop using drugs, treatment for managing opioid dependence, and psychosocial support to drug users and their families.
Signs/symptoms According to NICE, symptoms that suggest the possibility of drug misuse include acute chest pain in a young person, acute psychosis, and mood and sleep disorders.
Causes/risk factors Illicit drug use is often linked to a range of other factors such as mental health problems, alcohol misuse and homelessness, says NICE. In England and Wales, those aged between 16 and 24 are more likely to be frequent drug-users. Twice as many men as women report using cannabis. People who inject drugs are at risk of blood-borne viruses such as HIV and hepatitis
Expert comment Mike Flanagan is a consultant nurse in substance misuse services at Surrey and Borders Partnership NHS Foundation Trust
Find out more
B or C, and of developing injection-site infections. Children whose parents use drugs are at risk of abuse, neglect and developing their own substance misuse problems.
Treatment The NICE briefing highlights that interventions such as needle programmes are an opportunity to engage people in a range of harm reduction services, which can act as a gateway to other health and social care services.
How you can help your patient In places where drug misuse is prevalent, such as mental health settings, NICE recommends routinely asking service users about their drug use, including type, quantity and frequency. In primary care, hospitals and emergency departments, consider asking patients about drug use if they show symptoms. You can then give advice on reducing sexual and injection risk behaviours, and provide information about self-help groups. Avoid being judgemental.
‘One of the biggest barriers to accessing assessment and treatment for drug problems is stigma. To be able to help patients, nurses in all settings need to be aware of any preconceived ideas and prejudices they may hold. ‘All too frequently I see this highly marginalised, vulnerable group of people getting a raw deal in health and social
Drug use disorders NICE quality standard (November 2012): http:// guidance.nice.org.uk/QS23 Government drug strategy, Reducing demand, restricting supply, building recovery: supporting people to live a drug-free life (December 2010) www.gov.uk/government/ publications/drugstrategy-2010--2 Action on Addiction www.actiononaddiction. org.uk DrugScope www.drugscope.org.uk FRANK www.talktofrank.com
care settings. Perceiving drug addiction as simply self-inflicted may mean you are not empathetic in your nursing care. Drug misusers often have predisposing factors, such as a history of neglect and abuse, problems managing pain and mental health issues. Adopting an empathetic approach can have a profound impact in breaking harmful cycles of behaviour.’
18 july 2 :: vol 28 no 44 :: 2014 NURSING STANDARD Downloaded from RCNi.com by ${individualUser.displayName} on Nov 16, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
Illicit drug use ISTOCKPHOTO
Essential facts The national crime survey 2012/13 found that around 2.7 million people in England and Wales had taken an illicit drug in the past year, with about one third taking a class A drug. More than a third of adults have taken an illicit drug in their lifetime. In April 2013, the commissioning of substance misuse treatment services was transferred to local authorities, supported by health and wellbeing boards.
Tackling Drug Use NICE local government briefing (May 2014): http://publications.nice.org. uk/tackling-drug-use-lgb18 Needle/syringe programmes NICE public health guidance (April 2014): http:// guidance.nice.org.uk/PH52
What’s new In May, the National Institute for Health and Care Excellence (NICE) produced a local government briefing, Tackling Drug Use. Recommendations include more testing and treatment for blood-borne viruses among drug users, providing clean injecting equipment and other harm-reduction services through needle and syringe programmes, support for those who are trying to stop using drugs, treatment for managing opioid dependence, and psychosocial support to drug users and their families.
Signs/symptoms According to NICE, symptoms that suggest the possibility of drug misuse include acute chest pain in a young person, acute psychosis, and mood and sleep disorders.
Causes/risk factors Illicit drug use is often linked to a range of other factors such as mental health problems, alcohol misuse and homelessness, says NICE. In England and Wales, those aged between 16 and 24 are more likely to be frequent drug-users. Twice as many men as women report using cannabis. People who inject drugs are at risk of blood-borne viruses such as HIV and hepatitis
Expert comment Mike Flanagan is a consultant nurse in substance misuse services at Surrey and Borders Partnership NHS Foundation Trust
Find out more
B or C, and of developing injection-site infections. Children whose parents use drugs are at risk of abuse, neglect and developing their own substance misuse problems.
Treatment The NICE briefing highlights that interventions such as needle programmes are an opportunity to engage people in a range of harm reduction services, which can act as a gateway to other health and social care services.
How you can help your patient In places where drug misuse is prevalent, such as mental health settings, NICE recommends routinely asking service users about their drug use, including type, quantity and frequency. In primary care, hospitals and emergency departments, consider asking patients about drug use if they show symptoms. You can then give advice on reducing sexual and injection risk behaviours, and provide information about self-help groups. Avoid being judgemental.
‘One of the biggest barriers to accessing assessment and treatment for drug problems is stigma. To be able to help patients, nurses in all settings need to be aware of any preconceived ideas and prejudices they may hold. ‘All too frequently I see this highly marginalised, vulnerable group of people getting a raw deal in health and social
Drug use disorders NICE quality standard (November 2012): http:// guidance.nice.org.uk/QS23 Government drug strategy, Reducing demand, restricting supply, building recovery: supporting people to live a drug-free life (December 2010) www.gov.uk/government/ publications/drugstrategy-2010--2 Action on Addiction www.actiononaddiction. org.uk DrugScope www.drugscope.org.uk FRANK www.talktofrank.com
care settings. Perceiving drug addiction as simply self-inflicted may mean you are not empathetic in your nursing care. Drug misusers often have predisposing factors, such as a history of neglect and abuse, problems managing pain and mental health issues. Adopting an empathetic approach can have a profound impact in breaking harmful cycles of behaviour.’
18 july 2 :: vol 28 no 44 :: 2014 NURSING STANDARD Downloaded from RCNi.com by ${individualUser.displayName} on Nov 16, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
