Community drug services

Providing clinical services Community drug services... 

The focus here is on treatment within community drug services, as these have evolved in the face of changing demands. 

As already indicated, this chapter is a broad-brush picture of community services, which it is hoped will be of interest in areas and countries with other types of provision. The book in general concentrates on actual clinical treatment, and the special aspects of treatment in particular patient groups are discussed in the final chapter. Keeping matters very general, there have been three further significant trends in the development of community drug services in the UK. 

Much of the work of ours and other community drug services comes into the category of drug counselling, and this will now be examined in a little more detail. 

Much of the ethos of community drug treatment as it has developed has been firmly grounded in harm-reduction policies. There is frequent debate as to exactly what such principles entail, and even how appropriate they are in countries at different stages of development. Those interested in the philosophy are referred to a paper by AL Ball (2007) from the department of HIV/Aids at the World Health Organization, which clearly still sees avoidance of HIV as one of the key aims of this policy agenda. A short commentary on that article succinctly sums up the areas of importance in drug service provision, as follows ... 

Strang J, Donmall M, Webster A Tantam D (1991). Comparison between community drug teams with and without inbuilt medical services. British Medical Journal, 303, 897... 

This can be carried out either in an acute medical or psychiatric ward, or in a special drug-dependency in-patient unit. The advantages of the latter will include the initiation of a rehabilitation programme particularly geared towards the problems of addictions. However, some patients may well prefer a straightforward detoxification and then work in the community supported by other services, for example, from the Community Drug Team. There are several options for the in-patient detoxification of opiate dependents. These include ... 

In the middle years of the 1980s some of the new statutory services for problem drug takers started calling themselves Community Drug Teams (CDTs). This title reflected the similarity between their aspirations and those of other Community Teams, particularly Community Alcohol Teams (CATs) which had developed during the previous few years. It is too early to provide a comprehensive description and evaluation of these services this chapter looks at three very different examples in order to provide a snapshot of their organisation, philosophy, and operation. 

Pioneering Community Teams must almost inevitably work on a number of fronts. Equally they have to recognise the potential for conflict between their tasks. Thus commented the Social Services Inspectorate report on drug services in 1985, after examining three new CDTs (Social Services Inspectorate 1985). Where in the three teams described above do we encounter potential or actual conflict ... 

The Community Drug Team lessons from alcohol and handicap services... 

The problems associated with joint planning between local authorities and health authorities have been well documented elsewhere.29,30,31,32 Of particular relevance to alcohol and other drug services, however, are the findings of a recent survey that whereas 87 per cent of district health authorities had joint planning teams for mental handicap services, only 16 per cent had planning teams concerned with drug and/or alcohol services.33 The structure within which Community... 

U.S. Department of Health and Human Services. National Institute on Dmg Abuse. Club Drugs Community Drug Alert Bulletin. December 1999. 

Oversee cancer drug preparation and dispensing in patient care settings Direct patient care Investigational drug services Research Drug information Educational instruction Outcomes assessment Pharmaceutical industry Medical communications... 

Notes No information available or no programme reported + At least one programme reported ++ More than one programme reported Sources Reitox national reports 1999 Dagmar Hedrich, Community-based services for female drug users in Europe , Pompidou Group of the Council of Europe, unpublished report, December 1999. ... 

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