Addressing substance use and carrying out mini-interventions

Basic blocks of addressing substance use and carrying out mini-interventions 

 

​​​​​​​Early identification of risky use of intoxicants is one of the most important approaches for reducing the harm caused by intoxicants. The sooner you address the risk of alcohol use, the use of tobacco products or drugs or harmful gambling, the smaller the risks of serious problems and harm. Studies have estimated that, for example, at least one out of ten people with harmful or risky alcohol use who have received advice move to reasonable use after brief counselling or altogether stop their alcohol use. The effects of a mini-intervention for risky alcohol use are considered to continue for 1–2 years.

Encouraging interaction & research knowledge

Ethical activities that respect human dignity are of primary importance in both addressing substance abuse issues and carrying out mini-interventions.  These must address not only legal requirements but also aspects such as the culture and values of the target group. Information related to intoxicants and addictions must always be provided in a manner respectful to the recipient. The provided information must be truthful and research-based, openly justified, and useful and clear for the target group.

Tools for brief counselling

Addressing substance use and providing clients with brief counselling are important tools for all professionals in social services and health care. Professionals are recommended to always ask about alcohol use, smoking, gambling and drug use whenever a client arrives at an appointment because of a problem that may be caused by addiction or a substance abuse issue, including insomnia, mental health problems or financial difficulties. It is also a good idea to reserve time for addressing substance use and carrying out a mini-intervention if the client has been in an accident or has repeatedly asked for a sick leave. The Current Care Guidelines contain instructions for carrying out a mini-intervention for clients needing support for reducing or eliminating the risk or harmful alcohol use, smoking and drug use. (linkit sivussa?)

Remember that: 

• Alcohol use is often only perceived as a problem when it has already had visible consequences and adverse effects 
• Smoking should be addressed in all work with clients in health care at least once a year, as any use of tobacco products is considered to involve risks. 
• Addressing narcotics use may be challenged by the fact that drug use is a punishable offence, as a result of which clients often seek help because of other symptoms or problems. 
• Gamblers often only look for help at a point when their problem already seems insurmountable. 
• The problems may be disguised by other reasons for seeking treatment or be linked to other problems, such as a mental health disorder.

Intoxicated at an emergency clinic

A person who has been injured while under the influence should always be offered an opportunity to discuss substance abuse. The mini-intervention should be in proportion to the patient’s reason for visiting health care services, situation and illnesses. Patients and their loved ones are also provided with information on reducing substance use and the available electronic support services. Those working in emergency care also encounter substance risk users not reached by other health care services. Some of these clients can no longer be sufficiently helped by a mini-intervention, but instead need to be referred to substance abuse treatment due to their addiction issue and circle of harm caused by alcohol. It is important to book the first appointment as soon as possible after the emergency care visit.

Adult social work - substance abuse is not a private matter

While the majority of people with substance abuse problems or harmful gambling issues may not have yet been reached by substance abuse services, most of them use some social and health services. All adult social work clients should be asked about their intoxicant use. Substance abuse and gambling problems are social issues that are often linked to other problems central to social work.

Success in adult social work requires bringing attention to the harmful effects of substance abuse, and discussing them openly and in confidence, while listening to and encouraging the client- Professionals do not need - and should not - provide ready-made solutions, as it is best to look for these together with the client instead.

Substance abuse and mental health problems often go together

Individuals with both substance abuse and mental health problems form a special risk group for harmful substance abuse. In fact, in the context of assessing the risks of alcohol use, it may also be necessary to assess the person’s mental strain or depression. A gambling problem may be related to a mental health disorder or alcohol problem. Smoking, on the other hand, is more common among people with mental health problems than the population on average, and these individuals should be actively supported in giving up smoking.

Entries on substance use and mini-intervention

Using structured entries on addressing substance use and carrying out mini-interventions provides information on the client's method and amount of intoxicant use and how different services have prevented the harm caused by substance abuse and gambling, and supported smoking cessation. The information is used in contexts such as: 

• assessing clients’ service needs, 
• care planning, 
• assessing the desired change and resource management and 
•  developing service chains.

Operational management can use the accumulated information to monitor the implementation of decisions and plans, and allocate resources at different levels of the service chain. At the team level, the information obtained from the entries provides an opportunity to support and guide the primary work of employees as necessary.