Summary
UK clinical guidelines recommending interventions for people with harmful patterns of drinking and alcohol dependence, supporting and promoting good practice.
Contents
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This introduction sets out how to use the guidelines, their aim, who they are for, what they are and their scope. It also summarises information on alcohol-related harms and health inequalities.
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Experts through experience identified their priorities for providing high quality alcohol treatment and recovery. They emphasised the importance of personalised, non-judgemental treatment within a recovery-oriented system of care.
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These principles of care outline evidence-based approaches for supporting people with problem alcohol use. This includes building trusting relationships, reducing stigma, working with families and carers, and promoting inclusive services and a recovery-oriented system of care.
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How to use validated tools to identify health risk from alcohol use, deliver brief interventions to help people reduce their drinking or refer those with possible dependence to specialist assessment.
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How to assess a person's alcohol use and other needs, and agree their treatment and recovery goals, as well as interventions and actions to meet those goals. It covers risk assessment and regular reviews of treatment and recovery and risk management plans.
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How to provide evidence-based psychosocial interventions for people with alcohol problems. It covers formulation to identify appropriate psychosocial interventions for the person, structured support, psychological treatments and interventions for family members.
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Recovery support services and lived experience initiatives provide practical and emotional support and help people build long-term recovery. They have an essential role in a recovery-oriented system of care and include peer support, mutual aid groups and other resources.
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Employment support is an important part of recovery planning. Good links between treatment providers and employment services can help people navigate complex systems and make informed decisions about employment opportunities.
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How to deliver interventions to reduce health and social harms associated with a person's alcohol use. This includes assessing, planning and monitoring gradual alcohol reduction, and providing alcohol harm reduction advice across healthcare settings.
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How alcohol assertive outreach can engage and support vulnerable people with alcohol dependence who experience multiple disadvantage. This includes co-ordinating care through multi-agency teams to address complex needs and reduce health inequalities.
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How to provide pharmacological interventions for alcohol dependence, covering specific medications such as benzodiazepines for withdrawal management, acamprosate and naltrexone for preventing relapse and thiamine supplementation to prevent neurological complications.
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How to provide medically assisted alcohol withdrawal in community settings for people with moderate or, in some cases, severe alcohol dependence. It outlines when this approach is appropriate, covering assessment criteria, safety considerations, preparation and monitoring.
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The core specialist competencies and systems needed to provide specialist inpatient medically assisted withdrawal for people with severe dependence or complex needs. The chapter distinguishes between specialist inpatient withdrawal units and residential withdrawal settings.
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How community alcohol treatment and recovery services can provide accessible, trauma-informed, inclusive care. This includes how they work with health, care and recovery services to develop personalised treatment plans and deliver evidence-based interventions.
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Residential treatment and intensive structured day programmes for alcohol dependence aim to help people achieve abstinence and begin recovery through evidence-based interventions. This includes group work, individual support and planning for continuity of care in the community.
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How primary and community health services can routinely identify health risk from alcohol use and respond appropriately. GPs and their teams identify and manage alcohol related health conditions, provide harm reduction interventions and work with specialist alcohol services.
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How to care for people with alcohol-use disorders in acute hospitals, covering assessment, providing a multidisciplinary approach, managing withdrawal, treating complications and planning discharge to ensure continuity of care with community alcohol treatment services.
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How to deliver alcohol treatment interventions in police custody suites, prisons and other secure settings and for people with community sentences or on licence.
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How to support people with co-occurring mental health conditions and problem alcohol use, emphasising the 'everyone's job' and 'no wrong door' principles while outlining co-ordinated care across mental health and alcohol treatment services and evidence-based interventions.
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Healthcare assessments, treatment and recovery planning and referral pathways for primary or secondary healthcare for people with alcohol related physical health conditions including liver disease, cardiovascular disease, specific cancers, and smoking and lung health issues.
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How to prevent, identify, assess and treat alcohol related brain damage (ARBD) using brief cognitive assessment, harm reduction, multidisciplinary pathways for comprehensive assessment and treatment planning, adapted interventions for cognitive impairments and long term support.
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How to provide tailored alcohol treatment for people experiencing homelessness. It covers strategies for improving access and engagement, highlighting the need for multi-agency integrated care to address alcohol use, housing and wider needs while reducing health inequalities.
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How to identify, assess and respond to domestic abuse among both victims and perpetrators in alcohol treatment services. It covers safety planning, staff training, multi-agency approaches and appropriate referral pathways and working with specialist domestic abuse services.
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How to provide specialist alcohol interventions and support for children and young people. This includes assessment, care planning, multi-agency co-ordination, working with parents, safeguarding and the transition arrangements needed for young people moving to adult services.
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How to support women and other people who are pregnant to reduce or stop their alcohol use to reduce risks for the fetus and mother. It covers information and advice, multi-agency care planning, specialist treatment for alcohol dependence and support in the perinatal period.
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How alcohol treatment services can become accessible and effective for everyone, especially groups who face barriers to accessing care. This includes ethnic minority groups, LGBTQ+ people, women, older adults and people with learning disabilities or neurodevelopmental conditions.
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How alcohol treatment services can support parents and their children, including safeguarding responsibilities, working with children's social care and assessment and making referrals.
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How to treat problem alcohol use in UK armed forces personnel and veterans. It covers evidence-based interventions adapted for armed forces settings, the transition to civilian life and tailored support for veterans in community alcohol treatment services.
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An overview of relevant legislation and guidance from across the UK's 4 nations, covering child and adult safeguarding, mental capacity, carers and domestic abuse.
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This annex explains when people and healthcare professionals must notify the relevant agency about conditions such as alcohol use disorders that may affect driving safety.
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A summary of common alcohol withdrawal symptoms and serious complications of alcohol withdrawal. Alcohol treatment staff should be able to understand and recognise the signs of alcohol withdrawal.
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Members of the expert guidelines development group, the experts through experience group and small groups advising the development of these guidelines.
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An alphabetical list of technical words and terms and their meanings and definitions that are used in the UK clinical guidelines for alcohol treatment.