problems and services

The drugs section looks at the help available for alcohol and drug users and gives advice on finding an appropriate service

who are drug and alcohol services for?

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"What prevents me from going to a drugs service is the fact that even though I do have a drugs problem, I'm not an addict … they are really for … heroin junkies and injectors."

Tony, cocaine user

You don't have to be an 'addict' to have a problem with alcohol or drugs – or to get help.

In many cases, problems with drugs or alcohol occur when a situation simply gets out of hand or you're just not thinking very clearly. Lyndsay, 24, for example, says safe sex went by the board when she was using E: 'I took a lot of risks ... I didn't always use protection and I sometimes forgot to take the pill.' Similar scenarios include alcohol-related violence or drunk-driving, or accidents related to drug or alcohol use. Or you may simply be creating problems for yourself by occasional inappropriate and erratic behaviour at work, college, school or home.

For others, though, drugs or alcohol can be more of a long-term problem. Glen's emerging physical and mental dependence on amphetamines, for example, only became apparent gradually: 'I'm quite lazy … and have had confidence problems. Amphetamines seemed to solve both these. For six months I thought I was God ... the use gradually escalated until I was only sleeping three nights a week.'

Drug and alcohol services aim to help people with different problems – short- and long-term – in different ways. There are also services dedicated to helping the families and friends of drug users and problem drinkers (see families and friends), and, increasingly, special services aimed at women (see women's issues). All these services are confidential and are usually free. However, in some cases, and particularly for residential and substitute-prescription services, there may be a long waiting-list.

Interviewer: How do you know you've got a drug problem?

Steve: Um … you run out? … (laughs)… Um, good point … I guess you just know, don't you?

Steve, cannabis and amphetamine user

If you think you may have a problem, it's quite likely you do. Making a list of positives and negatives about your drug use may help clarify things. Or you could try answering the following questions – the more 'yes' answers you give, the more likely it is that you need to think about changing your use:

Do you have a favourite drug?
Do you ever use when you're alone?
Do you use drugs or alcohol because you're bored, lonely or anxious?
Do you think a lot about drugs or alcohol and their use?
Do you need to use more and more to get the effect you want?
Do you feel irritable or anxious if you don't use?
Do you miss your favourite drug if you don't use it for a while?
Have you made repeated failed attempts to give up or cut down?

You could also consider official definitions, such as the one from the Advisory Council on the Misuse of Drugs. Equally applicable to alcohol, this defines a 'problem user' as someone who is 'either experiencing or causing social, psychological, physical or legal problems related to their self-administration of drugs'. Any form of injecting drug use is also considered 'problematic'.

However, it's important to realise that the problems associated with drug and alcohol use are highly personal. What is a problem for one person is not necessarily a problem for someone else, and most services are happy to talk, reassure or help anyone who is concerned about their use (see first steps).

Some people get to grips with drug and alcohol problems without professional help – see DIY detox for practical advice on self-help. But it may be a lot easier with a more structured programme – or just a bit of friendly support.

first steps

There are three initial routes to getting help.

Telephone advice lines offer immediate access to general advice and a means of identifying sources of further help. They are often backed up by websites. The main helplines are listed in help and info at the end of this page. Such services are free – unless you go private – and confidential.

Street agencies are located in community settings and operate 'drop-in' policies, so drug users can usually attend at any time during opening hours. Similar help exists for alcohol users. As well as advice, information and referral to other services, some of these drop-in services have needle-exchange schemes, providing sterile injecting equipment to registered users.

Your local doctor/GP may also be an invaluable resource. If you aren't registered with a doctor, look in Yellow Pages for your nearest clinic, or ring the local council. Most GPs can help users assess their situation, provide interim health care, and where necessary make referrals to better-equipped services. GPs can also provide ongoing care for problem users, ranging from regular check-ups to the prescription of substitute drugs for opiate users. However, if you don't want to deal with your family doctor, or your GP doesn't seem sympathetic, all services are available via the alternative routes described above.

what's available?

community services

You can contact self-help groups directly (see help and info). Other community services provided by Community Drug (or Alcohol) Teams and Drug Dependency Units require a referral (see first steps above).

Structured counselling differs from the more general advice and information available from the open-access services described in first steps in that it involves more formal assessments and clearly defined treatment plans and goals.

Structured day programmes provide an alternative to residential rehabilitation for alcohol and drug users. Most of these schemes require you to attend between three and five days a week.

Community prescribing is primarily targeted at dependent opiate users and offers medically supervised substitute prescriptions of methadone or, more rarely, heroin. Both GPs and specialist doctors attached to a Drug Dependency Unit or Drugs Misuse Service provide such prescriptions.

Aftercare is targeted at users completing other programmes and aiming at complete abstinence.

residential services

Placements at residential rehabilitation units usually last 6-12 weeks – though they may be for longer – and give users time away from home to focus on their drug or alcohol use through counselling and other non-medical therapies. Unless funding the placement themselves, users cannot typically attend without a referral from another agency, and you will be assessed for a place by the local authority that will fund it. If you have private health insurance, your insurer might pay. (If you're being assessed for residential rehab, one important question concerns how you will manage when you return to the outside world, and what support you will need. You should start thinking at an early stage about the changes you may need to make in your home life and lifestyle.) Almost all units require users to be completely abstinent from alcohol or drug use. However, some units for heavy drinkers ('wet hostels') aim to work with people who are unwilling or unable to use other services.

Inpatient detoxification units provide medically supervised withdrawal for people with substance-misuse disorders.

alternative and private therapies

Alternative therapies such as acupuncture, hypnotherapy, homeopathic preparations and shiatsu massage are offered by some services (often street agencies or residential units). Unfortunately, such therapies are often the first to go when funding shortages occur. There's more information in our complementary medicine site.

Other private counselling and medical services, including 'rapid opiate detoxification', which claims to detoxify users in a matter of hours, are also available – at a price. You should be able to get more information about these from the sources mentioned in first steps.

help and info

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organisations

Addaction
67-69 Cowcross Street
London EC1M 6PU
Tel: 020 7251 5860 (Mon-Fri 9am-5pm)
E-mail: info@addaction.org.uk
Website: www.addaction.org.uk
Working solely in the field of drug and alcohol treatment, Addaction runs community-based and prison-based projects, plus specialist services for young people.

Alcohol Concern
32-36 Loman Street
London SE1 0EE
Telephone: 020 7928 7377 (Mon-Fri 9am-5pm)
E-mail: contact@alcoholconcern.org.uk
Website: www.alcoholconcern.org.uk
Alcohol Concern acts as the national umbrella body for 500 local agencies tackling alcohol-related harm and offering help to the families and friends of those with alcohol-related problems.

Alcoholics Anonymous
PO Box 1
Stonebow House
Stonebow
York YO1 7NJ
Helpline: 0845 769 7555 (24 hours)
Tel: 01904 644026
E-mail: aanewcomer@runbox.com
Website: www.alcoholics-anonymous.org.uk
Runs self-help groups throughout the UK. The only requirement for membership is a desire to stop drinking.

Cocaine Anonymous
PO Box 46920
London E2 9WF
Helpline: 020 7284 1123 (every day, 10am-10pm)
E-mail: helpline@cauk.org.uk
Website: www.cauk.org.uk
A network of self-help groups offering support for those wanting to recover from cocaine dependence.

Drinkline
PO Box 4000
Glasgow G3 8XX
Helpline: 0800 917 8282 (24 hours)
A free national helpline offering advice and information for people with alcohol problems or anyone concerned about alcohol misuse. Provide advice on sensible drinking and information on local support services to help people cut down on their drinking.

Drugsline
Helpline: 0808 1 606 606
Website: www.drugsline.org
Free and confidential crisis and support line and drop in support centre. Also offers individual counselling and education. Crisis line and drop in hours are 7.00pm to 10.30pm Mon to Thurs, Sunday mornings 10am to 1pm. At all other times you can leave a message and a telephone counsellor will call you back.

Drugscope
40 Bermondsey Street
London SE1 3UD
Tel: Office 020 7940 7500
Tel: Information Line 0870 774 3682 (Mon-Fri 10am-1pm) E-mail: infor@drugscope.org.uk
Website: www.drugscope.org.uk
National drugs information agency with services that include a library, a wide range of publications, policy research and consultancy.

FRANK
Helpline: 0800 77 66 00 (24 hours)
Textphone: 0800 917 8765
E-mail: frank@talktofrank.com
Website: www.talktofrank.com
Provides free confidential drugs information and advice 24 hours a day. All calls are confidential. Use the website's search facility to get the contact details of organisations offering practical help and support in your area.

Narcotics Anonymous
Helpline: 020 7730 0009 (every day, 10am-10pm)
E-mail: helpline@ukna.org
Website: www.ukna.org
A non-profit fellowship of men and women for whom drugs had become a major problem, who meet regularly to help each other stay clean. Recovery in NA focuses on the problem of addiction, rather than on any particular drug. The website has information for those who think they may have a drug problem, for professionals working with addicts seeking recovery and for recovering addicts.

National Treatment Agency for Substance Misuse
5th floor, Hannibal House
London SE1 6TE
Tel: 020 7972 2473 (Mon-Fri 9am-5pm)
Website: www.nta.nhs.uk
A special health authority established by the government to increase the availability, capacity and effectiveness of treatment for drug misuse in England.

Release
388 Old Street
London EC1V 9LT
Legal Helpline: 0845 4500 215 (Mon-Fri 10am-5.30pm)
Heroin Helpline: 0845 4500 215 (Mon-Fri 10am-5.30pm)
E-mail: ask@release.org.uk
Website: www.release.org.uk
Offers confidential and professional legal, health and welfare advice for those who come into contact with drugs. Can refer you to local drug agencies and specialist lawyers. The website features drug facts, information on the law, and advice for dealing with the police.

websites

Alcohol Concern
www.alcoholconcern.org.uk
Contains information about the work of Alcohol Concern, factsheets and details of publications, a directory of local alcohol services, and advice for those worried about their own or someone else's drinking.

Addiction Network
www.addictionnetwork.co.uk
Contains extensive information on alcoholism and other addictions. Offers advice, education, treatment options and more for professionals and the general public at large. Updated daily, it deals with technical enquiries through its 'Ask the Expert' facility and also has its own agony aunt.

Addiction Alternatives
www.addictionalternatives.com
A gateway to the world of 'how to' methods that can enable you to gain more control of your life whether you are seeking help for a family member, friend, or yourself. Has information, online quizzes, links and recommended resources.

Centre for Recovery from Drug and Alcohol Abuse
www.recovery.org.uk
Information and advice for those with a drug or alcohol problem, families and friends. Features facts about drugs, frequently asked questions, suggested reading and website links.

(revised February 2003, resources updated February 2005)