Care for alcohol and drug users

What is it about ?

The consumption ofalcohol and drugs can cause many problems, which go far beyond the health of the user. It threatens not only the health of the consumer, but generally also his direct contacts and those around him.

• An overdose can be fatal.
• The risk of infections – such as hepatitis B and C, infection with HIV and the tuberculosis – increases, especially when drugs are injected directly into a vein with a non-sterile needle.
• There is also a great risk of infections at the injection site (most often on the arms and feet), with the formation of ulcers and abscesses. Not to mention that several people sometimes use the same needles.
• Often the substance abuse is accompanied by psychic symptoms, like the psychosis associated with anxiety attacks and hallucinations. It is not uncommon for this to be linked to withdrawal or overdose.
• The risk of behavior unsuitable and imprudent is considerable, because the substance abuse reduces the ability to assess hazards. There may be multiple sexual partners without the use of condoms, which increases the risk of sexually transmitted infections (STIs).
• The risk of falling into petty or serious delinquency is increased because substance use is often financed by the sale of substances to others.

In the area of ​​consumptionalcohol and drugs, a good organization of care is essential if we wish to minimize the problems for the user and those around him. Consideration should be given not only to health issues, but also to hygiene, sterile needles, sexuality counseling, etc.

Aid should also be offered without conditions. Even if he is not yet convinced of having to wean himself completely, the consumer must be able to have access to care. And if he really wants to stop, appropriate care is required.

What are the possible treatments?

First aid and follow-up care

A substance abuse always carries a risk of overdose andpoisoning. With opioids, such as heroin, a risk ofrespiratory arrest exist. In this case, an antidote such as naloxone should be given immediately. The person must absolutely be observed in the hospital. His desire to wean can be assessed there. If necessary, she can temporarily take a substitute, such as methadone or buprenorphine.

The consumer can also develop psychic problems treble. If he represents a danger to himself or to his entourage because of these, an observation may be necessary. In this case, it is the treating psychiatrists who decide on the need for a prolonged admission, possibly in a detoxification center.

Outpatient support services

These services make their know-how and / or their equipment available to consumers and, if possible, help and support them. This can range from the provision of sterile syringes and condoms to support for withdrawal, to help with debt mediation or finding housing.

Weaning support

Suddenly stopping drugs oralcohol may cause withdrawal symptoms. The symptoms are of a different nature and of varying severity depending on the product consumed and the level of consumption. In the event of (risk of) severe withdrawal symptoms, admission is offered to a (hospital) department or to a specialized center.

During withdrawal, withdrawal symptoms may be alleviated by taking medication temporarily, such as a mild painkiller or sleeping pill. It is sometimes not possible to suddenly stop the consumption of substances and substitutes must be administered temporarily, under strict supervision. This is called substitution therapy. In case of heroin addiction, the substitution treatment generally used is based on methadone or buprenorphine. These substitute products are taken under the strict supervision of the doctor and pharmacist.

The withdrawal alcoholic can be organized in a withdrawal clinic, but also on an outpatient basis: in the latter case, you stay at home but you regularly visit a caregiver or a specialized center. Associations such as Alcoholics Anonymous (AA) can be helpful and support you both individually and in groups.

It is possible to be addicted to several substances at the same time: alcohol, drugs, medicines such as sedatives, sleeping tablets, painkillers, etc. Often times psychiatric problems are still added to it.

After the actual withdrawal phase, the person still needs follow-up for some time, mainly to create the opportunity to regain a place in society and to sever ties with friends and acquaintances who have a bad experience. influence on it. The healing phase can quickly last six months. There are different care organizations in this context, such as assisted housing services and outpatient psychiatric follow-up services.

Want to know more?

• Protecting yourself when using drugs – PPS – AIDS prevention platform
• Alcohol, Ecstasy, Speed, Internet, Cannabis, Cocaine, Sleeping pills or tranquilizers, Gambling, update on your consumption – Stop or else?

• Medicines for opioid dependence – CBIP – Belgian Center for Pharmacotherapeutic Information
• Naloxone – CBIP – Belgian Center for Pharmacotherapeutic Information

Are you looking for more specialized help?

• Alcohol aid – Le Pélican & Le center ALFA
• AA – Alcoholics Anonymous
• Infor-Drogues – Another listen
• Mental Health Services – The Social Guide

Source

Foreign clinical practice guide ‘Care for people dependent on alcohol or drug addicts’ (2000), updated on 08.09.2017 and adapted to the Belgian context on 27.11.2019 – ebpracticenet