week 3 addiction treatment system in Victoria

Question 1

what is the current centralised intake system?

Answer 1

Prior to 2012, each alcohol and other drug treatment service in Victoria would individually screen, assess, and intake all referrals and client presentations to their service. This resulted in clients having to repeat their story to each new service accessed. To reduce this occurrence, recent reforms have resulted in a centralised intake system, involving a state-wide screening and referral line (Directline), and catchment-based intake and assessment. All new clients progress through this system, and then can later transfer between alcohol and other drug services without having to re-tell their story. ACSO’s Community Offenders Advice and Treatment Services (COATS) provides a centralised intake and assessment service for clients referred by the criminal justice system.

Question 2

what is does the 15point strategic plan focus on, in terms of aims in reducing dealth, disease, injury and the social costs associated with alcohol and drug use

Answer 2

https://d2l.deakin.edu.au/content/enforced/1053512-HPS325_TRI-12021/T3%20I1.png?&d2lSessionVal=wBviVFiMqETtZQWQ7tahSpG6a&ou=1053512

Question 3

what does the state funded system services provide?

and what are the services targeted at?

Answer 3

There are a range of gambling, alcohol and drug-related treatment services available in Victoria. Most of these are available in regional and metropolitan Victoria, however, in some cases services are restricted to certain areas, such as drug “hot-spots”.

In addition, some services are offered on a state-wide basis from a centralised location. State funded services are free, although Residential Rehabilitation and Drug and Alcohol Supported Accommodation will charge a rental fee. The Drink Drive Program is a fee-for-service program and prices vary according to the agency.

In the context of gambling, each state in Australia is responsible for its own gambling regulation framework. Most states generally provide free treatment for people experiencing gambling-related problems along with help for their families, such as free telephone services (e.g., Gamblers Helpline), online services (e.g., Gamblers Help Online) or face-to-face counselling services (e.g., Gamblers Help). Some services offer peer support programs and multi-lingual counselling. The Victorian Responsible Gambling Foundation provides all of these services and more.

Service requirements
All services must:

Be targeted to people with serious problems resulting from their use of alcohol or other drugs or gambling behaviour;
Follow the principle of harm minimisation in the approach of funded drug treatment services. Harm minimisation focuses on reducing the harm to both the individual and society from alcohol and drug use;
Ensure continuity of care for clients through an appropriate case-management process;
Where services are offered to young people, agencies should ensure that programs are tailored to their needs, are accessible, have flexible hours, work closely with the young person’s family group and build strong links with other relevant agencies;
Provide education and information relating to alcohol and drug or gambling issues which will enhance prevention and harm minimisation;
Facilitate arrangements for the care of clients’ children while their parents are in the program; and
Operate under age, gender and culturally-sensitive protocols in relation to client care.

Question 4

what are some important aspects for services?

what is necessary for them to be effective?

Answer 4

• minimize the steps for people (more steps and hurdles the more they have to work)
• treat people with respect and dignity
• have experienced staff as frontline workers that are empathetic to people who come in and create a relationship to maximize the positive effects of the service.
• peoples needs all differ
• severity and complexities
• make sure the clients needs are identified and priorities them and then priorities them.
• they have to address multiple factors and therefore multiple services are necessary such as criminal justice, child protection, housing, mental health, councelling etc. partnership models in critical
• need to ensure that they are integrated

Question 5

what are the 4 broad treatment types in alcohol and drug treatment?

Answer 5

Behavioural therapies and support aimed at changing behaviour to reduce or cease alcohol/drug use
Withdrawal, which is described as a supervised process of physical withdrawal from dependency
Residential rehabilitation
Pharmacotherapy or substituting opiates with other drugs
Other services focus on a particular target group, for example, families, other peers or members of the Koori community.

Question 6

what does the counselling and behavioral therapies involve?

Answer 6

Counselling is provided by trained health professionals in order to treat those with drug or alcohol addiction. This may be conducted by: psychologists, general practitioners, consultant physicians, psychiatrists and/or social workers. Services that may be provided include: assessment, treatment and consultancy, outreach referral and ongoing case management.

Question 7

what do withdrawal services involve? and why do we need them?

Answer 7

-their is a physical dependence on the drug so when they withdraw they feel horrible, shaking, vomiting and this can then prompt people to continue consuming the drugs/alcohol
-inpatient system withdrawal, provide other drugs to help through the withdrawal.
-outpatient, get medical help in the home to withdraw from substance
generally recommend withdrawal service first

Question 8

what does outpatient/home based withdrawal involve?

what are the two different types?

Answer 8

Outpatient/home-based withdrawal is available to people whose withdrawal can be appropriately managed without admission to a residential service. While there are two types of outpatient/home-based withdrawal services, these terms are used interchangeably in the literature. The first is outpatient withdrawal, which involves the individual attending a series of intensive individual consultations over a short period, followed by ongoing counselling and support to help complete the withdrawal. The second is home-based withdrawal, which involves supporting an individual through withdrawal from dependent drugs and alcohol use in their own home or other safe accommodation. Community nurses or doctors visit the home to provide medical care, support and supervision to the client and their family throughout the withdrawal process.

Outpatient/home-based withdrawal is usually much safer than trying to manage drug withdrawal without support, as the withdrawal process can be dangerous and psychologically confronting. After the home-based withdrawal is completed, the individual is linked to other support networks such as counselling or drug and alcohol workers within their community and community-based services for ongoing support.

Question 9

what are some of the services in Victoria offering outpatient/homebased detoxification services?

Answer 9

Salvation Army Bridge Centre Home-Based Withdrawal
Alcohol & Drug Program - Drug Withdrawal Team, Geelong
Barwon South West Youth Alliance
DAS West Home-Based Withdrawal Service
Women & Children’s Drug & Alcohol Service Home-Based Drug Withdrawal Service
Peninsula Drug & Alcohol Program Outpatient & Home Withdrawal Service
Access Alcohol & Other Drug Services Home-Based & Outpatient Drug Withdrawal
South East Alcohol & Drug Services Home-Based Withdrawal Programs
Uniting Care Moreland Hall Home-Based Withdrawal Program
Western Region Alcohol & Drug Centre Youth Home-Based Withdrawal
Youth Substance Abuse Service Home-Based Withdrawal Support Service Frankston and Box Hill

Question 10

what do residential/inpatient withdrawal and rehabilitation centers involve?

Answer 10

Can be -6-12 month but also shorter ones.
some also involves learning new skills and how to functions in groups etc.

Residential/inpatient withdrawal involves a short stay in a community service or hospital. Services usually specialise in a particular type of addiction withdrawal such as Odyssey House Residential Rehabilitation who cater mostly for substance addiction, or Glen Iris Withdrawal Service who cater to youth drug and alcohol withdrawal. Most residential/inpatient withdrawal services will provide access to medical and psychological services. Drug and alcohol withdrawal will be discussed in greater detail in Topic 8.

Question 11

what are some residential/inpatient detoxification and withdrawal services in Melbourne and Geelong ?

Answer 11

eelong Youth Substance Withdrawal Services
Salvation Army Anchorage
Royal Women’s Hospital Chemical Dependency Unit
DAS West, Medical Withdrawal Service
Salvation Army Home-Based Withdrawal
Windana Society Drug Withdrawal Unit
UnitingCare Moreland Hall - Withdrawal Services
DePaul St Vincent’s Hospital - Community Residential Drug & Alcohol Withdrawal Unit
South East Alcohol & Drug Services (SEADS) - Drug Withdrawal Unit
There are also private withdrawal and rehabilitation units in the Melbourne area. These services are not covered by government Medicare, so there is a substantial out of pocket expense for service users. For example:

Warburton Clinic - Health Scope - Alcohol & Drug Clinic
Pinelodge Clinic Dandenong
Epworth Hospital - Drug And Alcohol Unit
Vaucluse Hospital Brunswick

Question 12

what does pharmacotherapy involve?

Answer 12

treating drugs with drugs.
eg. use methadone to treat heroin.
stabalisation without the euphoria.

Question 13

what is supported accommodation?

Answer 13

This is for people who do not have a stable home environment. It helps them achieve lasting change and assists in their re-introduction to the community. Services include, as a minimum, a day support worker from a community based setting, usually within public housing.

Question 14

what are some of the services for families and what do they involve?

Answer 14

Family drug help
There are many self-help groups such as Family Drug Support Australia and Family Drug Help for family members of drug users across the State. These groups provide a regular newsletter, support, information and advice for families.

Parent support program
Parent support programs are short-term therapeutic group programs for families of drug users, facilitated by drug and alcohol professionals. These programs provide strategies to promote ongoing communication between parents and their adolescent children around negotiating and setting guidelines on behaviour, advice to increase the repertoire of communication and negotiation strategies available within the family, assistance to deal with the anxiety surrounding the misuse of drugs, and assistance to develop supportive relationships - a key factor in the remission of substance misuse problems.

The main aim of the program is to increase the family’s capacity to respond effectively and consistently to the young person. It also aims to increase parents’ competence to cope with the impact of drug use through increased knowledge about drugs and treatment services, to increase their ability to cope with ongoing emotional distress and sense of isolation, and to assist a family member in treatment.

Services for Koori communities
Koori-specific alcohol and drug treatment services are provided to Aboriginal people who are affected (either directly or indirectly), or who are at risk of being affected, by alcohol and/or other drugs.

Koori Community Alcohol and Drug Workers undertake a number of activities to reduce the use of, and harm caused by, drug and alcohol in their communities. These activities include health promotion, information provision, education activities, development and maintenance of community linkages, referrals and counselling. These workers liaise with services in an advocacy role on behalf of the service user.

Question 15

what are some services specifically for young people?

Answer 15

There are a number of services available in Victoria specifically for young people. Youth Substance Abuse Service (YSAS) is a primary example of a support provider for youth with alcohol or drug problems.
their was widely available heroin in melbourne 1990s, they found that their wasn`t many services to young people in Victoria.
found they needed a different approach for youth.

Question 16

how is the youth system different?

Answer 16

age- 12-21 some have higher age rage up to 25.
-allowed to have more of impact on the clients eg, family work, schools, changing the environment
-more imbedded in other services such as child protection, justice
outreach- support delivered into their setting.
-recognizing the barriers to youth, not having skills to navigate the system, being appealing to young people in order to help them
-think about the areas that need help.
- more sensitive to development needs, different duty of care and strategies, maybe less talk based services and more behavioral

Question 17

what are some of the youth-based services?

Answer 17

Min component and difference
Youth outreach and support: Outreach services provide assessment, support and ongoing case coordination for young people in their own environment. In the Geelong region, this service is provided by Barwon Youth.
Youth residential withdrawal: Withdrawal services are provided through a community residential drug withdrawal service or hospital-based treatment.
Youth home based withdrawal: These services are provided for young people where the withdrawal is of a mild to moderate severity and the person can be supported by a family member or friend at home.
Youth residential rehabilitation: Comprising a 15-bed state-wide facility to provide 24 hour staffed residential programs that will provide a range of interventions for young people whose established use of drugs has caused them significant harm.
Youth supported accommodation: Provides a supportive residential environment to help young people achieve lasting change and assist in their re-introduction into the community.

Question 18

how to access the youth services?

Answer 18

-multiple pathways to access the service
-doesn`t need to go through a central intake, each service can be accessed individually
limitations;
-underfunded youth AOD services
-even though multiple pathways, sometimes they have to go through many different plans and services which can be confusing.
-sometimes services use adult intake which can be challenging for youth.

Question 19

what are some gambling services?

Answer 19

• helpline
• online help (like chat room to talk to, real-time, emails)
• face to face services (intake and assessment to get counselling)
• gambling anonyms
• block from gambling services (someone foces you not to come in to casino)

Question 20

what are the other systems that you work with in relation to drug and alcohol

Answer 20

-child protection, mandated child protection act, if you believe the child is at risk then have to report (this can be very tricky to navigate) as clients often know this.

• metal health, 2 difference systems, the two services need to work together but doesn’t always work.
• mental health will only see people with severe mental health issues
• if mild mental health then need to access other systems. GP and get referral.

Question 21

what are the ways people can be referred to drug and alcohol services though the justice system?

Answer 21

people in posession of small amount can go into treatment through the diversion program. if they don`t attending then they go through the justice system and get charged.
or if a crime has been committed under the influence, they go on bail and take part in a support program so help them and then a report is written to support the case.

another stream is when someone is found guilty and then they are referred for drug and alcohol. less incentive though because they already have sentence.

Question 22

what are the challenges in regards to forensic sides.

Answer 22

• challenges of working across the system, ak wanting different outcomes such as justice system want to stop reoffending where as health systems are focused on their health.
• referral pathway is a bit like a one size fits all approach, ak people might get referred but its the wrong service, can decide though through the service. some are also very high risk and for safety issues cannot provide services.

Question 23

what are the main functions of the child protection system?

Answer 23

he main functions of child protection are to:

Investigate matters where it is alleged that a child is at risk of harm;
Refer children and families to services that assist in providing the ongoing safety and wellbeing of children;
Take matters before the Children’s Court if the child’s safety cannot be ensured within the family;
Supervise children on legal orders granted by the Children’s Court; and
Provide and fund accommodation services, specialist support services, and adoption and permanent care to children and adolescents in need.
Some professionals such as doctors, nurses, police and school teachers are legally obliged to report suspected child abuse. In addition, any person who believes, on reasonable grounds, that a child needs protection can make a report to the Victorian Child Protection Service. It is the Child Protection worker’s job to assess and, where necessary, further investigate if a child or young person is at risk of harm.

Question 24

what are the three main referral points for police when dealing with offenders?

Answer 24

Illicit Drug Diversion Program
The aim of the Drug Diversion Program is to divert appropriate adult and juvenile offenders detected for the use and/or possession of a small quantity of an illicit drug (other than cannabis) into assessment and appropriate treatment.

Cannabis Cautioning Scheme
Cannabis Cautioning aims to prevent the involvement of drug (cannabis) offenders with the criminal justice system. The program targets adult offenders apprehended by police for the use and possession of small (non-trafficable) amounts of cannabis and involves the provision of a cautioning notice to offenders who meet the police criteria. A voluntary two-hour Cautious with Cannabis education program and referral for further information is offered to offenders.

Victoria Police e-referral system (VPeR)
VPeR is a consent based, non-crisis, non-family violence IT referral system for police who identify a person in need of assistance for one of the following 16 issue types: gambling, alcohol and drug misuse, victim support, at-risk youth, child welfare, offenders, legal information and advice, grief support, support after suicide, mental health, aged support, disability, financial support, road trauma support, homelessness and dispute resolution/mediation.

Question 25

what are the issues with the services being separated eg mental health and addiction.

Answer 25

-not addressing the needs of people with dual diagnosis.

however, it is more taxing on resources.

Question 26

what are the core principles of the mental health act 2014, the severe substance dependence treatment act 2010 and the gambling regualton act 2003

Answer 26

The Mental Health Act 2014
The Mental Health Act 2014 delivers major reforms to the mental health system, putting people with a mental illness at the centre of decision-making about their treatment, care and recovery. The Act also recognises the important role family and carers play in supporting family members in their recovery journey. At the heart of these reforms is a supported decision-making model that promotes strong communication between practitioners, patients and their families and carers. This means that people with a mental illness will be supported to make and participate in treatment decisions and to have their views and preferences considered and respected.

The Act promotes and enables voluntary treatment in preference to compulsory treatment wherever possible. Where compulsory treatment is necessary, it will be provided in the least restrictive and intrusive manner possible.

Severe Substance Dependence Treatment Act 2010
The Severe Substance Dependence Treatment Act 2010 provides for a brief period of detention and treatment of people with severe substance dependence in a treatment centre. It only applies to people with the most severe substance dependence who urgently require treatment to save their life or prevent serious damage to their health.

The Act provides a critical intervention that will give the person time out from their substance dependence, access to medically assisted withdrawal, a chance to recover their capacity and the opportunity to engage in voluntary treatment. It is a last resort treatment option for a very small group of persons who, without this life saving intervention, would most likely become permanently disabled or die.

Detention and treatment is limited to a maximum of 14 days, and is not targeted to people who are capable of making choices about their substance use, including refusing treatment.

Gambling Regulation Act 2003
The main objectives of the Gambling Regulation Act 2003 are to foster responsible gambling in order to minimise harm caused by problem gambling, and accommodate those who gamble without harming themselves or others. It also aims to ensure that: minors are neither encouraged nor allowed to gamble, that gaming on gaming machines is conducted honestly, that the management of gaming machines and gaming equipment is free from criminal influence and exploitation, that other forms of gambling permitted under this or any other Act are conducted honestly and that their management is free from criminal influence and exploitation, and that community and charitable gaming benefits the community or charitable organisation concerned. Further, the act aims to ensure that practices that could undermine public confidence in community and charitable gaming are eliminated and that bingo centre operators do not act unfairly in providing commercial services to community or charitable organisations.