SMMGP - Supporting good practice in drug and alcohol treatment

Supporting good practice in drug and alcohol treatment

Guidance Documents

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Access the Guidance Documents

The following items are arranged in chronological order of addition to the site, with the most recent at the top.

Commissioning Alcohol Identification and Brief Advice
- Health Innovation Network South London (Feb 2016)
"Local Authorities, Clinical Commissioning Groups (CCGs) and NHS England commission alcohol Identification and Brief Advice (IBA) to provide early identification and intervention of increasing-risk and higher-risk drinking. The purpose of the toolkit is to provide Commissioners with information that will assist in developing IBA pathways, which form part of an effective alcohol harm reduction system." See Health Innovation Network South London web site for more details.
- Adobe Acrobat Document
PDF (.pdf, 4.3MB)
Widening the availability of naloxone
- Department of Health, Medicines & Healthcare products Regulatory Agency, Public Health England (PHE) (Nov 2015)
"Regulations introduced on 1 October 2015 widened the availability of naloxone, a medicine which reverses the effects of a heroin (or other opiate) overdose. This factsheet explains the regulations and how they can be implemented." See the GOV.UK web site for more information.
- Adobe Acrobat Document
PDF (.pdf, 53K)
Naloxone Supply Protocol
- Inclusion (Sep 2015)
"This protocol aims to provide guidance on the supply of naloxone by Inclusion to service users, family members, hostels, carers and other groups for the purpose of temporarily reversing opioid overdose. This protocol is intended as a framework for the supply of naloxone injections by Inclusion employees and partner agencies within substance misuse services. This protocol applies to all staff volunteers and peers within Substance Misuse services who have direct contact with clients."
Microsoft Word Document
DOC (.doc, 232K)
Adobe Acrobat Document
PDF (.pdf, 176K)
Take-home naloxone from October 2015
- Public Health England (PHE) (Sep 2015)
"Naloxone, which can be effective in reversing heroin overdoses, is, from the 1 October 2015, more readily available for those that need it. Although naloxone will remain a prescription only medicine, the legislative change will crucially mean people working in drug treatment services are able to supply the drug, without a prescription, to anyone needing it to stop a heroin overdose. This document provides summary information about the situation after October 2015 and builds on PHE's February 2015 advice on 'Take-home naloxone for opioid overdose in people who use drugs', which still stands."
- Adobe Acrobat Document
PDF (.pdf, 515K)
Prescribing drugs of dependence in general practice, Part B - Benzodiazepines
- Royal Australian College of General Practitioners (RACGP) (Jun 2015)
This Australian guide from the RACGP "represents a synthesis of the best available evidence for benzodiazepine use in the primary care setting."
- Adobe Acrobat Document
PDF (.pdf, 1.7MB)
Bereaved Through Substance Misuse - Guidelines for those whose work brings them into contact with adults bereaved after a drug or alcohol-related death
- Centre for Death and Society (CDAS) (Jun 2015)
These CDAS guidelines are to help workers deal more supportively with relatives after a bereavement where the deceased was an individual who had misused substances (irrespective of whether or not these were the cause of death).
- Adobe Acrobat Document
PDF (.pdf, 2.3MB)
Guidance on the Clinical Management of Acute and Chronic Harms of Club Drugs and Novel Psychoactive Substances
- Novel Psychoactive Treatment UK Network (NEPTUNE) (Mar 2015)
This NEPTUNE document provides guidance on the clinical management of harms resulting from acute intoxication and from the harmful and dependent use of club drugs and NPS. The guidance is based on available evidence and clinical consensus.
- Adobe Acrobat Document
PDF (.pdf, 4.4MB)
Guidance for Healthcare Professionals on Drug Driving
- Department for Transport (Jul 2014)
A new offence of driving with certain specified controlled drugs in excess of specified levels in the body came into force on 2 March 2015. This guidance is intended to provide healthcare professionals with a clear explanation of the new legislation including the statutory "medical defence" available to patients who have taken their medicine in accordance with the advice of a healthcare professional and/or the information contained in the leaflet accompanying the medicine; and a reiteration of existing advice that healthcare professionals would normally consider giving to patients about taking medicines that could impair their driving.
- Adobe Acrobat Document
PDF (.pdf, 132K)
Alcohol and Other Drug Use: The Roles and Capabilities of Social Workers
- Manchester Metropolitan University (MMU) (Mar 2015)
"The first-ever national document to outline how social workers should respond when working with someone with alcohol and drugs problems has been launched. Leading social work and health organisations have joined forces with Manchester Metropolitan University (MMU) to create this document on the roles and capabilities for social workers when working with people with substance misuse problems."
- Adobe Acrobat Document
PDF (.pdf, 1.2MB)
Take-home naloxone for opioid overdose in people who use drugs
- Public Health England (PHE) (Feb 2015)
"Advice for local authorities and local partnerson promoting the wider availability of naloxone to reduce overdose deaths from heroin and similar drugs."
- Adobe Acrobat Document
PDF (.pdf, 151K)
Advice for prescribers on the risk of the misuse of pregabalin and gabapentin
- Public Health England (PHE), NHS (Dec 2014)
PHE and NHS England have published an expert group's advice for prescribers on the risk of misuse of pregabalin and gabapentin, and suggestions for a balanced and rational use of these medicines. The advice will be of use to local healthcare providers and clinicians.
- Adobe Acrobat Document
PDF (.pdf, 158K)
Non-medical prescribing in the management of substance misuse
- Public Health England (PHE) (Jul 2014)
This document defines clear parameters within which non-medical prescribing can be delivered safely and effectively within recovery-orientated drug and alcohol treatment systems.
- Adobe Acrobat Document
PDF (.pdf, 492K)
Guidance for the use and reduction of misuse of benzodiazepines and other hypnotics and anxiolytics in general practice
- Chris Ford, Fergus Law (Jul 2014)
This guidance has been produced to aid all clinicians and other practitioners in the use of, and reduction of misuse of benzodiazepines (BZ) aimed at primary care. Other hypnotics and anxiolytics, including the "Z-drugs" (zopiclone, zolpidem, zaleplon, eszopiclone) are mentioned briefly.
- Adobe Acrobat Document
PDF (.pdf, 483K)
Prescription and Over-the-Counter Medicines Misuse and Dependence
Factsheet 4: Treatment

- RCGP Substance Misuse and Associated Health (SMAH), SMMGP (Jun 2014)
How are patients who misuse and/or become dependent on prescription-only or over-the-counter medicines treated? A factsheet for primary and community care practitioners.
- Adobe Acrobat Document
PDF (.pdf, 235K)
Prescription and Over-the-Counter Medicines Misuse and Dependence
Factsheet 3: Identification

- RCGP Substance Misuse and Associated Health (SMAH), SMMGP (Jun 2014)
How are patients who are misusing or dependent on prescription-only or over-the-counter medicines identified? A factsheet for primary and community care practitioners.
- Adobe Acrobat Document
PDF (.pdf, 251K)
Prescription and Over-the-Counter Medicines Misuse and Dependence
Factsheet 2: Prevention

- RCGP Substance Misuse and Associated Health (SMAH), SMMGP (Jun 2014)
Steps to avoid misuse of and dependence on prescription-only and over-the-counter medicines. A factsheet for primary and community care practitioners.
- Adobe Acrobat Document
PDF (.pdf, 245K)
Prescription and Over-the-Counter Medicines Misuse and Dependence
Factsheet 1: The Problem

- RCGP Substance Misuse and Associated Health (SMAH), SMMGP (Jun 2014)
Prescription and over-the-counter medicines misuse and dependence. A factsheet for primary and community care practitioners.
- Adobe Acrobat Document
PDF (.pdf, 264K)
The role of addiction specialist doctors in recovery orientated treatment systems: A resource for commissioners, providers and clinicians
- Public Health England (PHE) (Jun 2014)
"Addiction specialist doctors can be a vital resource to local alcohol and drug recovery systems, and have a crucial role in championing recovery, ensuring this is visible throughout the system, and supporting commissioners and providers in delivering recovery-orientated systems. This document, agreed by Public Health England (PHE), the Royal College of Psychiatrists (RCPsych) and the Royal College of General Practitioners (RCGP), builds on the standards described in "Delivering quality care for drug and alcohol users: the roles and competencies of doctors" and identifies a number of essential functions which can usually only be carried out by addiction specialist doctors. They are required for a properly balanced, flexible, continually-improving and progressive local alcohol and drug recovery system, which is capable of meeting a full range of need."
- Adobe Acrobat Document
PDF (.pdf, 716K)
Optimising opioid substitution treatment -
"Turning Evidence into Practice" Briefing

- Public Health England (PHE) (Jan 2014)
"Although opioid substitution treatment (OST) is the most effective intervention for heroin use and dependence, the medication itself, and accompanying psychosocial/recovery interventions, need to be optimised to give the user the best chance of recovery and sustained abstinence. This briefing focuses on elements that can be optimised and provides key messages to help achieve this. The content is drawn from authoritative guidance, published evidence and service provider feedback."
- Adobe Acrobat Document
PDF (.pdf, 127K)
Medications in recovery: Best practice in reviewing treatment
- Recovery Orientated Drug Treatment Expert Group (Dec 2013)
Supplementary advice from the Recovery Orientated Drug Treatment Expert Group
- Adobe Acrobat Document
PDF (.pdf, 368K)
Medications in recovery: Re-orientating drug dependence treatment
- Recovery Orientated Drug Treatment Expert Group (Jul 2012)
"The task of the Recovery Orientated Drug Treatment Expert Group has been to describe how to meet the ambition of the Drug Strategy 2010 to help more heroin users to recover and break free of dependence..."
- Adobe Acrobat Document
PDF (.pdf, 853K)
Recovery-Orientated Drug Treatment: An interim report by
Professor John Strang, chair of the expert group

- Recovery Orientated Drug Treatment Expert Group (Jul 2011)
"In 2010, the NTA asked me to chair a group to provide guidance to the drug treatment field on the proper use of medications to aid recovery..."
- Adobe Acrobat Document
PDF (.pdf, 671K)
Managing persistent pain in secure settings - A guide for professionals working in custody settings
- Public Health England (PHE) (Jul 2013)
"This guide is an overview of best practice in managing persistent pain and describes how this practice might be implemented in secure environments, including prisons, police custody and immigration removal centres. It offers advice on confirming a diagnosis of persistent pain in a secure setting."
- Adobe Acrobat Document
PDF (.pdf, 467K)
Commissioning treatment for dependence on prescription and over-the-counter medicines: a guide for NHS and local authority commissioners
- Public Health England (PHE) (Jun 2013)
Commissioning guidance for the NHS and local authorities on how to respond to the needs of people who are addicted to medicines. The guidance sets out PHE's expectation that support should be available in every area for people with a dependency on prescription or over-the-counter medicines, based on a full assessment of local need.
- Adobe Acrobat Document
PDF (.pdf, 757K)
Alcohol Use Disorders: Harmful Drinking and Alcohol Dependence -
Evidence Update 28

- NHS Evidence & NICE (Jan 2013)
A summary of selected new evidence relevant to NICE Clinical Guideline 115 "Alcohol use disorders: diagnosis, assessment and management of harmful drinking and alcohol dependence" (2011).
- Adobe Acrobat Document
PDF (.pdf, 395K)
Primary care drug and alcohol treatment:
Commissioning and provision against a backdrop of localism

- RCGP & SMMGP (Jan 2013)
This joint paper considers the future impact of the changing commissioning environment on primary care drug and alcohol treatment. It considers the specific challenges and opportunities for primary care, being uniquely placed to respond to this in a period of significant change as part of the wider health and social care economy.
- Adobe Acrobat Document
Executive Summary
PDF (.pdf, 162K)


Adobe Acrobat Document
Full Paper
PDF (.pdf, 202K)
Delivering Quality Care for Drug and Alcohol Users:
The Roles and Competencies of Doctors

- RCPSYCH & RCGP (Sep 2012)
A guide for commissioners, providers and clinicians.
The guide provides a clear analysis of the medical competencies involved in working with drug and alcohol users. It is also intended as timely assistance in the transition towards new commissioning arrangements for drug and alcohol services in 2013.
- Adobe Acrobat Document
PDF (.pdf, 391K)
Guidance for the use of substitute prescribing in the treatment of opioid dependence in primary care
- Chris Ford, Kate Halliday, Euan Lawson & Elsa Browne; supported by Nigel Modern, Charlie Lowe, Nazmeen Khideja, Penny Schofield & Richard Watson (1st Edition, Feb 2011. Updated 08-02-2012)
Opioid dependence is common in the UK and there are effective substitution medications, including methadone and buprenorphine, to support treatment. This guidance covers the use of substitute medication, which can be an important element in the treatment of opioid dependent patients and their medically assisted recovery (MAR).
Guidance for the use of substitute prescribing in the treatment of opioid dependence in primary care
Digital Publication
Adobe Acrobat Document
PDF (.pdf, 2.3MB)
Guidelines for Community Dose Induction (CDI) & Assessment
- Adapted from "Slaying the Dragon" - the Birmingham Shared Care Guide produced by a partnership of Birmingham GPs, Drug Solutions Birmingham & the Birmingham Drug Action Team (May 2006)
- Adobe Acrobat Document
PDF (.pdf, 56K)
Flow Chart for Community Dose Assessment (CDA)
Using Supervised Consumption (SC) with Daily Dispensing

- Adapted from "Slaying the Dragon" - the Birmingham Shared Care Guide produced by a partnership of Birmingham GPs, Drug Solutions Birmingham & the Birmingham Drug Action Team (May 2006)
- Adobe Acrobat Document
PDF (.pdf, 40K)
Methadone Guidelines
- Annette Verster & Ernst Buning, Euro-Methwork (Jan 2006)
Read on the Victorian Government Health Information Web Site
Read on the Euro-Methwork Web Site
-
Buprenorphine - Critical Questions Answered
- Annette Verster & Ernst Buning, Euro-Methwork (Jan 2006)
Read on the Victorian Government Health Information Web Site
Read on the Euro-Methwork Web Site
-
Alcohol and Other Drugs - A Handbook for Health Professionals
- National Centre for Education and Training in the Addictions (NCETA) (Oct 2005)
Read on the NCETA Web Site
Read on the NCETA Web Site
-
Methadone Guidelines: Prescribers & Pharmacists
- Victorian Government Health Information (Oct 2005)
Read on the Victorian Government Health Information Web Site
Read on the Victorian Gov Health Info Web Site
-
Australian Alcohol Guidelines: Health Risks & Benefits
- National Health & Medical Research Council (NHMRC) (Oct 2005)
Read on the NHMRC Web Site
Read on the NHMRC Web Site
-
Guidelines for the Treatment of Alcohol Problems
- National Drug & Alcohol Research Centre (Oct 2005)
Read on the Australian Government Dept of Health & Ageing Web Site
Read on the Australian Gov Dept of Health & Ageing Web Site
-
US NIH Consensus Statement on the Effective Medical Treatment of Heroin Addiction
- US National Institute of Health (Oct 2005)
Read on the NIH Web Site
Read on the NIH Web Site
-
RCGP Guidance for Hepatitis A & B Vaccination of Drug Users in Primary Care & Criteria for Audit
- RCGP & SMMGP (Apr 2005)
- Adobe Acrobat Document
PDF (.pdf, 703K)
RCGP Guidance for Working with Cocaine & Crack Users in Primary Care
- RCGP & SMMGP (Nov 2004)
- Adobe Acrobat Document
PDF (.pdf, 706K)
RCGP Toolkit for General Practitioners & Primary Care Organisations
Criteria, Standards & Evidence Required for Practitioners Working with Drug Users

- RCGP & SMMGP (Updated Nov 2004)
- Adobe Acrobat Document
PDF (.pdf, 334K)
CJIP - Clinical Guidance to Maximise Access to Drug Treatment
- Criminal Justice Intervention Programme (Jul 2004)
This document aims to provide additional guidance to inform the work undertaken by Criminal Justice Intervention Programme teams in relation to their role in providing and facilitating access to drug treatment.
- Adobe Acrobat Document
PDF (.pdf, 58K)
Hepatitis C Testing Proforma + Back-up Information
- RCGP Sex, Drugs & HIV Task Group (Updated Mar 2004)
This proforma is designed to record and prompt appropriate discussion prior to Hepatitis C testing and to ensure fully informed consent is obtained prior to testing. It states that it should be used in conjunction with the accompanying sheet "Hepatitis C testing: back-up Information".
- Adobe Acrobat Document
PDF (.pdf, 25K)
Starting Methadone Safely
- RCGP Sex, Drugs & HIV Task Group (Mar 2004)
This article provides some guidance and for GPs who are not so familiar with caring for drug users.
- Adobe Acrobat Document
PDF (.pdf, 10K)
Clinical Guidelines & Procedures for the Use of Buprenorphine in the Treatment of Heroin Dependence
- AusInfo for Commonwealth Dept. of Health (Jun 2001)
Read on the Australian Dept. of Health & Ageing Web Site
Read on the Australian Dept. of Health & Ageing Web Site
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Notes About the Guidance Documents

Some of the documents can be read online as standard web pages (Read Online), whilst others can be downloaded as Adobe Acrobat (Adobe Acrobat Document) documents for viewing and/or printing in their original format.

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Downloadable versions are provided as Adobe Acrobat PDF documents, and are labelled "PDF" in the table above. Please see Help with Download Documents if you need more information.

Readers should note that great care is taken to try and ensure all information contained in these documents is correct at the time they are published, but that details may change over time. The older the document, the more likely it is that details such as contact names and addresses, or links to 3rd party web sites, may have altered.