If a person wants treatment to tackle their drug addiction, they are entitled to NHS care in the same way as anyone else with a health problem. A GP is often a starting point. The GP can either initiate treatment themselves or refer to a specialist drug treatment service. Alternatively, a direct pathway can be created from another service (such as a homelessness service) to the local drug treatment service. 

Please note that, to enter a specialist drug treatment service, an individual must be registered with a GP in the area.

Community drug treatment

Community drug treatment services normally operate from a central base, but can also deliver services from satellite clinics, such as GP surgeries. The frequency that someone will need to attend will depend upon their individual circumstances. 

Initial appointment

At the first appointment for drug treatment, staff will ask about drug use. They will also ask about work, family and housing situation. A urine or saliva sample may be taken and analysed. Staff will talk through all of the treatment options and agree a treatment plan for the individual to sign. They can also explain local support groups for the individual and their families or carers. A keyworker will be allocated, who will provide support throughout the treatment journey.

What does drug treatment involve?

This depends on the personal circumstances and what substances the person is addicted to. The keyworker will work with the individual to plan the right treatment support for them.  Treatment options may include:

  • Talking therapies

    such as cognitive behavioural therapy (CBT), help to see how thoughts and feelings affect behaviour. These can be delivered on a one-to-one, or group basis

  • Treatment with medicines

    if there is a dependency to heroin or another opioid drug, a substitute drug may be offered, such as methadone or buprenorphine. This means people can get on with treatment without having to worry about withdrawing or buying street drugs.

Please note that medication is titrated, meaning that the desired dosage may take time to be achieved as there is usually a lower starting dose that is gradually increased until the individual is comfortable with the dose and is not feeling withdrawal symptoms. Individuals may be asked to take medication in front of a staff member (supervised consumption) until they have abstained from illicit use.

  • Medication

    is either provided directly from the drug treatment premises, or from a local Pharmacy.

  • Detoxification (detox)

    or people who want to stop taking opioid drugs like heroin completely. Detox can be offered in the community, in a primary care setting (hospital in-patient) or within a residential rehab environment.

Please note that certain criteria must be met in order to consider this as an option, which is usually decided by a multi-disciplinary panel made up of drug treatment senior staff and local authority commissioners.

  • Shared Care

    this is when treatment is transferred to primary care settings and delivered jointly by a professional from the drug treatment service and a GP. This option is available once the individual has achieved stability with their treatment regime and heavily reduced or abstained from any illicit drug use.

  • Family members, friends and professionals

    can be added to the individual’s confidentiality agreement, so that information on treatment progress can be discussed, but note that this is only if the individual agrees. 

Through and aftercare

Individuals who are progressing with treatment should be supported in engaging in positive activity at every conceivable opportunity. For people who have managed to successfully complete drug treatment, it is just as important that there is a comprehensive plan after they leave the treatment service. This may be directed by the drug treatment service, but ultimately it is up to the individual to decide what they would like to do in order to preserve and sustain their long-term recovery. 

Some of these options include:

  • Volunteering
  • Undertaking qualifications
  • Building bridges with family members, or non-drug using friends
  • Engaging with mutual aid and self-support groups
  • Entering abstinence-based recovery housing
  • Employability activities 
  • Finding a hobby or taking up a sport
  • Leisure/social activities

If your service has a number of individuals either accessing drug treatment or that have successfully completed treatment, you may want to consider a setting up a ‘Recovery Support Group’, so that people can discuss their individual experiences with their peers in a safe and therapeutic environment.

Needle exchange programmes

Needle exchange programmes or NSPs are free, harm reduction, social programmes that allow people who inject drugs intravenously, to obtain sterile injecting equipment. NSPs can be delivered by specialist services (such as drug treatment services) or in community settings (mostly Pharmacies). Homelessness services can work with drug treatment services to deliver needle exchange in hostel/day centre settings.

People accessing the service should be offered a range of equipment, such as different sized syringes and needles, sterile cups, vitamin C sachets, condoms, filters, sharps boxes and other essential equipment.  The person using drugs is encouraged to access drug treatment (if not already doing so) and other health related matters can be discussed with the lead pharmacist or dispensing staff. Consultation rooms should always be used to discuss confidential matters and to dispense the equipment.