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Assessment and screening for substance use in practice

Observe how an assessment and a screening for drug or alcohol use is carried out in practice.
Patrick, we haven’t seen you in years. How you been keeping?
I’ve been doing OK. Yeah. Just trying to keep myself busy, you know what I mean? But it’s not easy sometimes. What’s been going on? Well I still live in the same area, thank god. But last year, my mum died. And I’m lost without her, actually. It’s been hard, you know, being on your own. But I don’t talk to them, my family. I saw them at a funeral, but that’s it. And all my friends are gone.
I don’t have anybody now. I’m so sorry to hear about your mum, Patrick. I know you two were close. So how you’ve been coping? Well, I was all right when I finished here last time. But when Mum died, it pushed me over the edge and I bought one bag, then another. Before I knew it, I was injecting again. It’s the crack. It’s the crack. It’s the worst though because all the money goes on that. Between heroin and the crack and the benzos, my head’s a mess. So it sounds like losing your mum was the trigger for your relapse of drug use. I completely understand. It must be hard for you.
Can I ask if you’ve kept up with your HIV appointments? Not since I was here the last time. But I don’t share needles. I wouldn’t do that. OK. So it seems like there’s a few things we need to sort out. Perhaps we should start with your drug usage and potential alcohol usage so we can figure out the best plan moving forward. Then when you’re feeling a bit stronger, if it’s OK with you, I’d like to explore some options to help you with the grief you’re experiencing. To start with though, do you mind if I ask you a few questions so we develop a care plan together? No, go ahead, Nurse. Fire away. OK.
So I’m going to ask you 11 questions and each of those questions has a range. I want you to tell me which answer best describes your situation.
So to start with, how often do you use drugs other than alcohol, never, once a month or less often, two to four times a month, two to three times a week, or four times a week or more. Every day, Nurse. A good few times a day. And do you use more than one type of drug on the same occasion? Yeah. I would smoke crack a good few times a day and I’d inject a bit of gear to bring it down a bit. I take sleepers every day too. OK. So you smoke crack cocaine, inject a bit of heroin, and take benzos every night. OK.
And how many times do you take drugs on a typical day when you are using drugs. It’ll be six or seven times a day. Maybe more. It’s getting really bad, to be honest. Well, it’s good that you’re here. That way we can work together on reducing your usage. Next question. How often–
OK. So Patrick, it doesn’t look like we need to follow up with your alcohol usage. With your substance usage, however, you have come in at a 40, which suggests that you’re struggling quite heavily with drug dependency. At this point, I think it’s best for you to be involved in drug therapy, only to get you in a more safer and more stable position in life. If it’s OK with you, I would like to arrange a review for the doctor? Yeah. It was a bit of a shock when we went through the questions. I realised it’s got pretty bad. I’m worried about the HIV too. I know I should be on treatment, but– Yeah.
Well, you’re here now and that’s the important thing, because we can get the ball rolling. So your treatment plan should come by tomorrow. And I’m also going to give you the details for the nearest needle exchange. It will be good for you to reach out for them so you can get some clean equipment to keep you safe. If it’s OK with you, as well, I would also like to organise a follow-up appointment at the hospital? Do you remember Anna the HIV nurse specialist? She still works there and she’d love to still see you. Sure. OK. Thanks. Thanks. In a few weeks, we’re going to check back in on you.
And if you’re feeling OK, I would love to explore some options with the grief you’re experiencing. Does that sound OK with you? Yeah, fair enough. Fair enough. I need the help with the drugs now. I want to get my health back. Absolutely.

Within this step we observe how an assessment and a screening for drug or alcohol use is carried out in practice.

We see how the nurse listens to the concerns and challenges being experienced by the client. The nurse then suggests they explore and measure the clients recent substance use and how the client is currently feeling. Before the client leaves the nurse has set up an appropriate appointment as the first step in the care plan.

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Identifying and Responding to Drug and Alcohol Addiction in Nursing, Midwifery and Allied Healthcare Practice

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