Substance misuse education in social work practice

A study of substance misuse education in social work is described. Social work courses do not always address substance misuse education, even though there have been many attempts to highlight the importance of social workers being equipped to deal with issues relating to alcohol or other drug use. This paper describes the importance of the inclusion of substance misuse in social workers' education and describes the development of a substance misuse module on the MSc, Diploma in Social Work programme at the University of Wales Swansea. The module is evaluated in three stages: (1) from the conclusion of the module; (2) at the end of the second social work practice placement; and (3) 9 months after the commencement of practice. The conclusions emphasize the students' use of the contents of the course, and their positive attitudes towards intervention. Suggestions for future research are included.     

Drug misuse at work

Doctor J joined the A&E team as a locum senior house officer to cover sick leave. She had trained in New Zealand and had been doing a number of locums in the UK over the last year. Sister T had been working with Doctor J for three days and found her work to be of a very high standard. She was confident and skilled in all aspects of A&E care and the rest of the staff enjoyed working with her. At 11 am one Friday morning, Staff Nurse R reported to Sister T that she could not find Doctor J. On conducting a search of the department, the staff toilet was found to be locked with no answer to knocking. The cubicle was broken into the Doctor J was found unconscious with an empty ampoule of pethidine and a needle still in situ in her thigh muscle. Doctor J was quickly transferred to the resuscitation room, where she was successfully resuscitated. What would be the most appropriate next steps?     

Substance misuse and mental health: an overview

Patients with dual diagnosis of substance misuse and mental health problems present many challenges for nurses, as their complex needs make them difficult to manage and treat. The author provides an overview of the nature and extent of the problem and a framework for nursing interventions.     

Substance misuse in acute general medical admissions

We conducted a prevalence study of current substance misuse amongst acute general medical admissions, and compared the sociodemographic profile of this group of patients with total admissions and the local catchment population. Patients were included in the study if they were resident in the Lambeth, Southwark and Lewisham (LSL) Health Commission catchment area and were aged between 18 and 85 years. The prevalence of non-dependent misuse was of particular interest. Of 2988 acute admissions, 609 (20%) were identified as misusing alcohol and/or drugs, 277 (9%) being identified by the admitting doctor and 332 (11%) being identified by means of a Health and Lifestyle Questionnaire (HLQ) which included the Alcohol Use Disorders Identification Test (AUDIT). The majority 437 (72%) of the identified patients had an alcohol problem. A smaller proportion, 116 (19%) were currently using illegal drugs and 56 (9%) were polydrug users. Compared with patients who misused either drugs or alcohol, alcohol misusers were more likely to be older and Irish, whereas users of illegal drugs were more likely to be younger and Black. Significantly more 'at risk' drinkers were identified by the AUDIT questionnaire than by the admitting doctor. This study supports the policy of routine screening for health-damaging behaviours and the implementation of health promotion strategies in general hospitals.     

Substance misuse and serious mental illness: spiritual care

BACKGROUND: People with a dual diagnosis of serious mental illness and substance misuse may be difficult to treat. This article explores how spirituality can be integrated into community care plans of these patients. It highlights the importance of including spirituality in pre- and post-basic-education programmes. CONCLUSION: Nursing models that integrate the positivist, existential and spiritual approach to understanding and caring for those with a dual diagnosis should be developed. Nurses could develop support groups along the lines of Alcoholics Anonymous to provide support to this group of clients. The use of complementary therapies by those with a dual diagnosis is an area of possibilities. The challenge is now to integrate spirituality into the already established biopsychosocial approach to caring for those with a dual diagnosis.     

Substance misuse, offending and mental illness: a review

The literature concerning the associations between violence, mental disorder, comorbidity and substance misuse are discussed in this review, which focuses on the findings of several international studies that demonstrate significantly higher rates of violence in substance misuse and dual diagnosis (when compared with 'single' diagnosis groups). The need for the development of an effective psychiatric nursing response in terms of assessment, liaison and joint clinical management approaches to those with a dual diagnosis is discussed in the context of United Kingdom Government legislation and policy in both forensic mental health services, and in statutory substance misuse services.     

Portrait of social work

Social work is concerned with enhancing the well-being of people within their social contexts. It is a broad profession with diverse practices. These range from a focus on the personal distress of individuals to the collective arrangements and social processes that influence the well-being of groups and communities. The unique contribution of social work to the caring professions is its broad contextualised approach to addressing human needs. Yet this breadth of scope also provides fertile ground for competing discourses within the profession. This paper provides an overview of the 'highly contested' nature of social work's goals, theories and methods of practice.     

Portrait of social work

Social work is concerned with enhancing the well-being of people within their social contexts. It is a broad profession with diverse practices. These range from a focus on the personal distress of individuals to the collective arrangements and social processes that influence the well-being of groups and communities. The unique contribution of social work to the caring professions is its broad contextualised approach to addressing human needs. Yet this breadth of scope also provides fertile ground for competing discourses within the profession. This paper provides an overview of the 'highly contested' nature of social work's goals, theories and methods of practice.     

Haemochromatosis: work and social implications

Hereditary haemochromatosis is prevalent in our society and requires vigorous and lifelong treatment. Diagnosis of the disorder may be delayed or missed due to its nonspecific symptoms and diverse manifestations. This can have lifelong consequences for the sufferer. Early diagnosis prevents severe organ damage and premature death and leads to a normal productive life. Screening family members will enable early diagnosis of those with the HFE gene mutation. The stigma attached to having a genetic condition may have consequences for job opportunities and for life and health insurance. Education of the community (including workplaces and employers) as well as health service providers will not only increase the likelihood of early diagnosis of haemochromatosis but will ease the social consequences of suffering from this disorder.     

Substance misuse, anxiety and depression and urgency of presentation to a public emergency department in Australia

Objectives: To establish the prevalence and comorbidity of substance‐related problems and anxiety and depression, among ED presentations, and to compare the prevalence of these conditions among more and less urgent presentations. Design and setting: Cross‐sectional survey of ED presentations over a 14 day period (24 h/day) at the Gold Coast Hospital Emergency Department in south‐east Queensland, Australia, in October 2002. Measures: Usual level of alcohol consumption (Alcohol Use Disorders Identification Test), acute alcohol and illicit drug use (during 24 h prior to interview), symptoms of anxiety and depression (Hospital Anxiety and Depression Scale) and triage category (Australasian Triage Scale). Results: Thirty‐one per cent of the sample reported usually consuming alcohol at a hazardous or harmful level. Twenty per cent of participants reported clinically significant levels of anxiety and/or depression, which were in turn significantly associated with hazardous and harmful levels of alcohol use. Hazardous/harmful alcohol consumption was over‐represented among less urgent ED presentations, whereas anxiety and depression were more prevalent among more urgent ED presentations. Conclusions: Emergency departments in Australia are appropriate settings for the detection of both substance use and mental health problems in the wider community. The prevalence of these problems in ED settings is high and there is a need for the development of systematic screening and referral processes. The evidence of a link between urgency of presentation and these problems needs to be further explored.