Problems with alcohol or drug use
IAPT has produced a positive practice guide for working with people who use drugs or alcohol (click here for the full guidelines).
In summary IAPT should be considered suitable if:
- The client is able to attend sessions and has motivation to limit their drug or alcohol use. This is demonstrated by control of their drug or alcohol use and / or when it is limited to clearly circumscribed contexts.
- The client is stable, i.e. using medication as prescribed and not using additional non-prescribed medication or illicit drugs. This would include clients on opioid substitution programmes (usually methadone or buprenorphine). No one should be excluded from IAPT services because they are being prescribed substitute medication.
- The client has a history of drug or alcohol use but is now abstinent.
However, IAPT would not initially be suitable if:
- The client is dependent on illicit drugs or alcohol and not in contact with a treatment service. These clients would be likely to benefit from referral to a drug and alcohol treatment agency for specialist assessment and a care plan that targets their substance use (e.g. LASARS).
- The client is in treatment with a drug or alcohol treatment service but unable to make changes in their substance use as a consequence of mental health issues. In such cases, standard keyworking in the addictions service would continue to work on these issues until some stability is achieved.