Addiction Service

We aim to provide an individually tailored, non-judgemental, confidential and accessible service to adults who are experiencing problems with alcohol or drugs. We offer a range of approaches, which include community-based assessment, treatment, management and support, and inpatient hospital treatment if indicated. About us: The Addiction Service is formed of a multi-disciplinary team of Health and Social Services staff (including nurses, social workers, psychologists, medical staff and occupational therapists) who provide addiction services to the resident population within Homefirst Community Trust and the neighbouring Causeway Trust. We aim to provide a range of treatment options in partnership with voluntary, community and statutory agencies, involved in the reduction and management of alcohol and drug related harm in the community. We also provide a consultation and training service for all health and social care professionals. The quality of service provided is consistently reflected in awards obtained. In 1998 and 2001, the Addiction Service at Parkmore Drive was awarded the Charter Mark for excellence of service provided for individuals with an addiction problem. We are comprised of three main departments: The Addiction Service, Parkmore Drive The Addiction Service, Railway Street Carrick 1 Inpatient Unit, based at Holywell Hospital Our commitment: Everyone who uses our service will be: treated and cared for by professionally trained staff with specialist skills; treated with courtesy and respect at all times; given the rights and dignity afforded to all people including the right to refuse treatment; supported throughout their treatment by a range of counselling services; given information on the range and type of treatment available; encouraged to take an active role in agreeing a treatment plan; offered an appointment within 6 weeks of being referred; given a choice of available clinics and appointment times; and seen within 30 minutes of the appointment time.

Links: The Addiction Service, Parkmore Drive The Addiction Service, Railway Street Carrick 1 Inpatient Unit, based at Holywell Hospital Referral and assessment procedure Are you concerned about your drinking? Are you concerned about your drug use? Auditing our performance Satisfaction survey results Useful telephone numbers

Addiction Service Parkmore Drive

1 Parkmore Drive, Ballymena, BT43 5DT,Tel: 028 2565 8462

email: enquiries.cas@homefirst.n-i.nhs.uk

Who we are:

The Addiction Service (Parkmore Drive) is a locally based treatment service that offers treatment, advice and information to individuals over the age of 18 years who are experiencing problems with alcohol or drugs.

What we do:

The Parkmore Drive service recognises that people develop difficulties with alcohol and other substances for a variety of reasons.

A range of treatments are available and treatment plans are developed in agreement with the client and their individual therapist.

Treatment options include:

Family members/ carers are encouraged to become involved in the individual’s assessment and treatment programme.

Clinics:

Local clinics are provided throughout Homefirst and Causeway Trusts in the following areas:

Opening hours:

The service operates between the hours of 9.00am – 5.00pm, Monday – Friday. You can contact the service using the above details. All enquiries are welcome.

Addiction Service Railway Street

105a Railway Street, Ballymena, BT42 2AF Tel: 028 2563 1970

Who we are:

The Railway Street Addiction Service offers advice, support and treatment in a community-based setting to individuals over the age of 18 years who are experiencing problems with drug use, particularly injecting heroin use. The service is confidential and non-judgemental.

What we offer:

The Railway Street service offers a range of individually tailored treatment options and treatment plans, developed in agreement with the client and their key-worker.

Treatment options include:

Open clinics

Advice/ support

Assessment/ harm minimisation

Information/ education

Community assisted withdrawal from substances

Substitute prescribing for injecting drug users

Long-term engagement and vocational training

Open Clinics:

The service operates Open Clinics on Tuesdays and Thursdays between 1.30pm – 4.00pm. New clients and individuals already known to the service are welcome to attend these clinics (without an appointment) whereby information is offered and brief assessments are carried out with a view to longer-term engagement and commitment.

Opening Hours:

The service operates between the hours of 9.00am – 5.00pm, Monday to Friday. You can contact the service using the above details. All enquiries are welcome.

Addiction Service, Inpatient Unit, Carrick 1

Carrick 1, Holywell Hospital, 60 Steeple Road, Antrim, BT41 2RJ Tel: 028 9446 5211

Who we are:

Carrick 1 is a 10-bedded Inpatient Unit based at Holywell Hospital. It aims to provide treatment in a supportive and non-judgemental environment for adults over the age of 18 years who have alcohol or drug problems.

What we offer:

Carrick 1 offers inpatient detoxification from alcohol, heroin, prescription drugs and a range of other substances.

Where appropriate, the service can also initiate and stabilise clients on substitute medications to help reduce relapse.

In addition to appropriate medical treatment, Carrick 1 provides a treatment programme consisting mainly of education and information, which incorporates a harm minimisation and relapse prevention approach. The programme is delivered in both individual and group settings.

Patients have the right to participate fully in all aspects of their treatment and are encouraged to do so.

Carrick 1 also offers support and information to relatives.

Duration of Stay:

Length of stay varies depending on individual need, however it generally ranges between one and four weeks.

Referrals – Information and Guidance

To ensure efficient management of referrals, the Addiction Service operates a centralised referral system with referrals accepted from GP’s, hospital doctors or consultants. If you would like a referral for yourself, please contact one of those people to request this.

All referrals are assessed and screened at community level; only those requiring inpatient treatment are transferred to the Addiction Service at Carrick 1.

To assist services to operate effectively, clearly indicate the nature of the client’s problem and the urgency of required assessment.

Please note: Referrals received to the service that do not provide adequate information of the necessity of an urgent appointment may be re-classified as a routine referral.

For any individuals with a drug or alcohol related problem residing in the Northern Board, please forward referrals in writing to:

The Addiction Service (Parkmore Drive), 1 Parkmore Drive, Ballymena,

BT43 5DT. Tel: 028 2565 8462

Routine referrals will be seen within 6 weeks, urgent referrals within 2 weeks. Referral agents will be advised of the outcome of the referral.

Or For individuals who have an injecting drug problem, please forward the referral to:

The Addiction Service (Railway Street), 105a Railway Street, Ballymena

BT42 2AF, Tel: 028 2563 1970

Clients are normally seen within 2 days at the open clinics.

Assessment

A member of the clinical team will assess all individuals at a community level. On initial contact, a member of the Addiction Service will carry out a comprehensive assessment to meet the following objectives:

Facilitate the identification of the presenting problem

Clarify the client’s aims and objectives to achieve change

Identify treatment required in order to begin the process of planning the most appropriate methods of intervention.

The assessment aims to establish:

Personal/ family history

Pattern of substance abuse (type/ frequency/ quantity)

Level of dependency

Degree of substance related harm (physical, psychological and social)

Motivation and commitment to engage in treatment

The referral agent will be notified of initial contact with the client and proposed follow up.

Following assessment, if it is indicated that a medical assessment is required, this will be arranged with the Consultant Psychiatrist (Substance Misuse), which may then result in a period of inpatient treatment.

If you have any concerns about any of the following:

Physical condition – Refer directly to an A&E department or medical outpatient clinic for further management

Mental health condition – Refer directly to the Crisis Response team or the sector Psychiatric Team for further advice and management

Pregnant drug and alcohol users – Discuss referrals for inpatient treatment with the medical staff in Carrick 1 Inpatient unit. To do so, phone 028 9441 3290 between 9.00am – 5.00pm, Monday - Friday

Are you concerned about your drinking?

Below is a standardised questionnaire used by many addiction services to tell if someone is psychologically or physically dependent on alcohol. This questionnaire should be taken together with information regarding many other aspects of a person’s situation.

It is only to be used as a guide and if you are concerned about your drinking you should contact your GP or an addiction specialist. Print this page and circle the score you feel is most appropriate for the question – be honest!

	Never	Sometimes	Often	Nearly Always
1. Do you find it difficult to get the thought of drink out of your mind?	0	1	2	3
2. Is drinking alcohol more important than your next meal?	0	1	2	3
3. Do you plan your day around where and when you can drink?	0	1	2	3
4. Do you drink in the morning, afternoon and evening?	0	1	2	3
5. Do you drink for the effect of alcohol?	0	1	2	3
6. Do you drink as much as you want without considering what you have to do the next day?	0	1	2	3
7. Do you drink when you know you should be doing other things?	0	1	2	3
8. Do you know that you won’t be able to stop drinking once you start?	0	1	2	3
9. Do you drink as much on weekdays as you do at weekends?	0	1	2	3
10. The morning after a heavy drinking session, do you need your first alcoholic drink to get you going?	0	1	2	3
11. The morning after a heavy drinking session, do you wake up with a definite shakiness of hands?	0	1	2	3
12. After a heavy drinking session, do you wake up and retch or vomit?	0	1	2	3
13. The morning after a heavy drinking session, do you go out of your way to avoid people?	0	1	2	3
14. After a heavy drinking session, do you see things, which you later realise, were imaginary?	0	1	2	3
15. Do you go out drinking and next day find you have forgotten what happened the night before?	0	1	2	3

Add up your scores.

A score from 0 to 10 indicated slight dependence;

A score from 11 to 20 indicates mild to moderate dependence and

A score of 21 and above indicates severe dependence on alcohol.

This questionnaire is only to be used as a guide. If you are concerned about your drinking you should contact your GP or an addiction specialist.

Are you concerned about your drug use?

Below is a standardised questionnaire used by many addiction services to tell if someone is psychologically or physically dependent on drugs. This questionnaire should be taken together with any information regarding many other aspects of a person’s situation.

It is only to be used as a guide and if you are concerned about your drug taking you should contact your GP or an addiction specialist.

	Never	Sometimes	Often	Always
In the last month did you think your use of drugs was out of control?	0	1	2	3
In the last month did the prospect of missing a hit (line, dose) make you very anxious or worried?	0	1	2	3
In the last month did you worry about your use of drugs?	0	1	2	3
In the last month did you wish you could stop?	0	1	2	3
How difficult would you find it to stop or go without drugs?	Not difficult	Quite difficult	Very difficult	Impossible
	0	1	2	3

A score of more than 4 using this questionnaire suggests that a person may be dependent on drugs.

Addiction Service - Auditing Our Performance

Each year we carry out audits of our service performance against our current service standards by looking at a random sample of cases referred to the service.

We used a review of 100 Parkmore Drive case notes to:

assess the service's response time to referrals and written communication with referral agents

compare current performance with previous years

The main findings of the audit for the last three years were:

File Audit		2003	2004	2005
Waiting time for normal appt	less than 3 weeks	17.1%	10.5%	35.6%
	less than 6 weeks	69.7%	67.4%	86.2%
Waiting time for urgent appt	less than 1 week	65.0%	28.6%	30.8%
	less than 2 weeks	75.0%	71.5%	61.5%
Feedback to GP in	less than 1 week	91.0%	78.0%	89.0%
	less than 8 weeks	95.0%	96.0%	*97.0%
* From 2005 onward, feedback to the GP is recorded as being less than 6 weeks

We also audited clients waiting times at clinics over the last three years in our Parkmore Drive service and the last two years in our Railway Street service with the following outcomes:

Waiting Times Survey – Parkmore Drive	2004	2005	2006
Less than 30 minutes	99.5%	99.0%	98.9%
Less than 15 minutes	98.0%%	94.3%	94.6%

Waiting Times Survey – Railway Street	2005	2006
Less than 30 minutes	96.5%	93.1%
Less than 15 minutes	81.6%	98.1%

Addiction Service - Service Users' Satisfaction Levels With Our Service

We aim to carry out an audit of our service users' satisfaction with levels and quality of service provided by the Addiction Service, Parkmore Drive by issuing questionnaires to patients who attended our clinics, each alternate year usually in March. The purpose of the survey is to obtain patient's views and satisfaction levels with the level and quality of our service.

Over the last three years, the audit has demonstrated the following:

Satisfaction Survey – Parkmore Drive	2001	2002	2005
Little difficulty accessing the service	93.7%	97.8%	93.8%
Given appointment promptly	91.9%	88.9%	89.6%
Given enough notice for first appointment	96.8%	100%	100%
Little difficulty finding the service	100%	93.3%	89.6%
Waiting areas clean	100%	100%	93.8%
Appointment times convenient	98%	100%	89.6%
Treated politely	100%	97.7%	97.9%
Therapy of benefit	100%	95.5%	91.7%
Involved in treatment decisions	100%	100%	95.9%
Offered a range of treatment options	98.1%	92.1%	85.4%
Quality of care so far - Good or Excellent	93.5%	95.5%	95.8%
Know how to complain	71.9%	60.5%	62.5%

We aim to carry out an audit of our service users' satisfaction with levels and quality of service provided by the Addiction Service, Carrick 1 by issuing questionnaires to patients when they are discharged from the ward. The purpose of the survey is to obtain patient's views and satisfaction levels with the level and quality of our service.

The previous two audits of the Inpatient Satisfaction survey have demonstrated the following:

Satisfaction Survey – Carrick 1	2003	2005
Good or excellent quality of service	66.6%	92.0%
Service effective in meeting needs	53.3%	91.0%
Would recommend treatment programme to a friend	80.0%	96.7%
Service helped to deal with problems	73.3%	84.1%
Satisfied with service	73.3%	92.0%
Satisfied with accommodation	100%	95.5%
Staff always helpful and courteous	87.5%	95.6%
Would come back for help if needed	86.7%	95.5%

Useful telephone numbers:

Information Updated August 2006