ASM 3

Support Individuals Who Are Substance Misuser's

Illegal substances that can be bought illicitly fall into three main categories, Stimulant,
Hallucinogenic and Sedative, all having different effects on the mind and body. Stimulant's
are used to create an increased heart rate and speed up the central nervous system, thus giving
a heightened sense of confidence and stamina. They can be in a powder form, solid crystals
or tablets. the most common being cocaine which can be snorted in the powder form, or
smoked when in crystal form which is far more potent. also commonly available are
Amphetamines which come in a pill form all have the same effect of creating a false sense of
Euphoria. Diluted pupils and heightening of blood pressure are common side effects of using
these drugs. Hallucinogenic substances like LSD or Magic Mushrooms are mind changing
drugs with unpredictable effects on individuals, with hallucinations and unpredictable mood
swings. Sedative's are taken for the opposite effect of stimulants to induce a state of calmness
both mentally and physically. Substances like heroin an opiate based substance is highly
addictive and can manifest itself in suppressed emotional and mental state with warm,
pleasurable and a sense of comfort which lasts a few hours until the body craves more.
Prescribed drugs that can be misused such as Benzodiazepines and Barbiturates are sedatives
which are commonly prescribed by GPs to treat symptoms of anxiety and depression, they
induce a state of sedation, and can alleviate the intense feelings associated with these
conditions.
Alcohol and Cannabis have depressant properties and are commonly used to induce a state of
relaxation, Alcohol when used excessively can cause damage to the bodies major organs such
as the liver and kidneys whilst Cannabis can cause extreme paranoia and memory issues as
well as respiratory problems.
Over the counter solvents are commonly used to give the same effects of Alcohol mainly by
teenagers, these include propellant gases, Paint , Glue, Lighter fuel and aerosols etc which are
inhaled to get the desired effect, although they reach the brain extremely quickly the effect is
very short lived. The Intoxicating Substances Supply Act 1985 makes it illegal for high street
retailers to sell to persons under the age of eighteen.
There are many health risks associated with substance use both short and long term, the
worse scenario being fatality. All substances work by stimulating different parts of the human
body, to either heighten or subdue, including the brain. Different substances or drugs used
have a varied range of short term effects including increased or decreased heart rate, high
blood pressure, mood changes and even paranoia, tremors etc. Increased use and thus long
term use can cause an individual to become dependent with more risk and effects manifesting
including heart attack, serious respiratory problems. organ damage and immune
deficiencies being the long term health risk dangers obtained from the
use of substances

Legislation concerning and applying to the use and storage of substances,

is The Misuse of Drugs Act 1971, The Misuse of Drugs Regulations 2001
and The medicine Act 1968. These were introduced to monitor the use
and supply and storage of Controlled substances and medicine drugs
prescribed or purchased at pharmacies or from authorised outlets and
those supplied or stored on site and for clients who have medication to
store at home In. The new amendment which made it a criminal offence
for people to knowingly allow premises they own, manage, or have
responsibility for, to be used by any other person for:

administration or use of any controlled drugs.

supply of any controlled drug.

the production or cultivation of controlled drugs, such as growing

cannabis.

Professionals could be prosecuted if they knowingly, allowed any of these

things to occur on work premises. CRI have policies and procedures in
place to the same effect if an incident did arise, the same applying to
people with regard to their own homes.
There are many factors that influence individuals to use substances, and
reasons why they decide to reduce or cease. These could be
experimentation where a person for the first time through curiosity will try
a substance for the effects, the thought brought on by themselves or it
could be through peer pressure, or an individual trying to be a part of a
social group or involved in something to feel good or satisfy emotional
issues. Family breakdown or poor background and upbringing and
environmental surroundings can be a cause or reason why a person would
decide to use a substance, negative emotional or an unstable family life
can commit a person into starting to use a substance to change the way
they feel, blot out or to escape. Drug use by family or siblings can set an
individual off to want to start using a substance as learnt behaviour
evolved especially from a young age can manifest as normal behaviour
and so is and replicated in life which could lead on to addiction and harder
drug use. Genetic or psychological characteristics could also be a factor
why people use substances.
Talking and dealing with emotional baggage can help aid abstinence or
reduced substance use as individuals who carry a lot of suppressed
emotional negative thoughts or feelings can want to use and continue to
do so for a prolonged period of time to cope, and if they can get the
opportunity to open up and express their feelings and their using habits,

to someone who understands and listens, that can really help and turn
things around for them. As a CRI recovery worker that is what I try and
achieve when working with a client by talking to them about its dangers
and effects. In key work sessions, groups and when advice or information
is sought.
Clients in the first stages of their journey accessing CRI called change,
come in and are still using or reducing before they are treated for their
problem. Depending on the drug they are using advice and information is
given in the activities involved with the method of use as so to practice
safe use and harm prevention and reduction.
Individuals who still use substances (Heroin, Amphetamines etc.) and
inject as a method of use are supported by CRI by way of a needle
exchange service which operates within its services. Giving individuals an
opportunity and chance to be able to collect or pick up clean sterile
injecting equipment (syringes) to use as prevention measure as to avoid
contamination and infection by using dirty equipment. These are given out
free along with advice in the way of leaflets and brief intervention with
workers on arrival. Individuals who inject also are given a free secure
sharps yellow bin which they are advised to use to dispose and contain of
their dirty equipment safely; these are signed for by an individual with
additional information on storage and harm reduction and prevention
offered in leaflet form.
Harm reduction strategies are implemented throughout CRI services
Nationwide and it is provided and introduced by the government health
department and the NTA (National Treatment Agency) to provide
information and advice to reduce drug related harm related to blood borne
viruses, overdose and Alcohol use. The essential components of CRIs
Harm Reduction service or intervention consists of harm reduction advice
and information being available throughout the whole of the treatment
programmes which CRI run, in groups and one to one sessions, leaflets
and pamphlets with harm reduction information is readily available to take
away.
The potential effects and difficulties that could arise from trying to cease
substance use and are otherwise known as withdrawal symptoms or
cravings which are a mental or emotional desire of wanting to re use the
substance of choice. These feelings can manifest in many ways both
physically, emotionally and mentally depending on the substance, and can
without support or treatment cause an individual to lapse or relapse.
Withdrawal symptoms which can manifest include sweating, tremors,
heart palpitations, nausea, diarrhoea, headaches, irritability, seizures and
anxiety.

Reducing is advised, but medical attention by way of a supervised Detox

is the best way to treat this as it minimises withdrawal symptoms and the
danger of complications.
Individuals who access CRI for treatment are supported in a respectful and
professional manner and are accommodated in the relevant manner, as to
the drug they have used or what condition they may be in mentally or
physically, should they present intoxicated they are asked to leave the
premises and to come back or rebook an appointment when they are in a
more stable and coherent state.
When assisting and supporting individuals who commit to reducing their
substance use, depending on what substance it is, individuals needs are
always taken into consideration, be it cultural, religious, disablement ,
mental or physical all can be catered for. Aftercare is such an important
part of our treatment package which is always available to all clients.

There are many specialist agencies and support networks we can access
for further support which can help and could also be connected to an
individuals recovery from substance use, also required by some clients
as part of their personal recovery capital support is in the way of mutual
aid groups. Agencies involved in a individuals treatment journey whilst
accessing CRI would include specialist agencies like; Social Services,
Bereavement or Housing, Hospital services which would be accessed to
obtain information or help and support into whatever the relevant problem
or issue.
I always ensure any information gathered when dealing with a client i.e.
recent substance use, criminal activity, change of circumstance etc is
reported to the relevant agencies and also entered on our CRiiS database.
As part of care coordination I try and have a review with my clients every
four weeks where we discuss how their reduction plan is going, is it going
to quickly, to slowly and the reasons for this, also exploring whether the
final objective is still the same. I remind them again of all available
support available to them as an individual. Going through their last review
paperwork we re-examine their own personal goals, star outcome chart
and treatment outcome profile to explore any progress or maybe
shortfalls. whatever the results of this being either good or bad, I always
try and stay positive and never fail to show enthusiasm. The outside
agencies that can be of great help to the individual are the various mutual
aid groups be it AA, NA, CA or SMART Recovery. we also have Intuitive

Recovery and Air Sports who work very closely with CRI at Newham,
providing extra support for the client's in the community.