Substance Misuse Management in General Practice (SMMGP)

Substance Misuse Management in General Practice

News & Events

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Latest News from the SMMGP

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SMMGP Clinical Update #42 - October 2014 now online

(Posted 21 October 2014)
The SMMGP Clinical Update #42 - October 2014 is now available in the SMMGP Clinical & Policy Updates section in both online and downloadable versions.

If you would like to receive these Updates via e-mail as soon as they are released, please join the SMMGP. Membership is completely free, you can join instantly online, and there are lots of benefits - see the Free SMMGP Membership Application page for more details.

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SMMGP Policy Update #39 - September 2014 now online

(Posted 21 October 2014)
The SMMGP Policy Update #39 - September 2014 is now available in the SMMGP Clinical & Policy Updates section in both online and downloadable versions.

If you would like to receive these Updates via e-mail as soon as they are released, please join the SMMGP. Membership is completely free, you can join instantly online, and there are lots of benefits - see the Free SMMGP Membership Application page for more details.

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August 31 is International Overdose Awareness Day

(Posted 25 August 2014)
Everyone is encouraged to add their voice to a day calling attention to reducing the global scale of drug fatalities.

The best estimates, from the United Nations Office on Drugs and Crime (UNODC) indicate that nearly 200,000 people die each year from drug overdoses.

The international community needs to talk more about overdose and how to drive down the number of deaths. International Overdose Awareness Day, an initiative of Penington Institute, is a day for raising a united voice for preventing overdose, for saving lives.

It is hoped that as many groups as possible stage events and let their communities know the campaign is an international day of action. Last year events were held around the world, including in Australia, Bahrain, Belgium, Canada, China, India, the Slovak Republic, the United Kingdom and the United States.

Hopefully this will be just the beginning. Grassroots community level action is at the heart of the day because it shows that people lost to drug overdose are individuals and family members, not just statistics. Often the strongest supporters of the day are the families of overdose victims who do not want other families to suffer as they have.

Therefore many groups are marking the day by staging a memorial event in conjunction with an overdose response training session. Momentum is building for making overdose prevention programs available to all who need them, and marking the day by informing as many people as possible can save lives.

Staging an event need not be complicated. For ideas go to www.overdoseday.com. Supporting materials to help event organisers are being continually updated.

Register events on www.overdoseday.com, or visit their Facebook page.

Post your observations or Tweet your ideas about the campaign at @OverdoseDay using the hashtag #OD14.

And don't forget that wearing the silver badge shows you support overdose prevention and remembrance. Badges can be ordered at www.overdoseday.com.

For more information please contact:

Royal Abbott
Penington Institute
95 Drummond Street
Carlton Victoria 3052
Australia
Tel: +61 (3) 9650 0699
Mob: +61 421 184 027
E-mail: r.abbott@penington.org.au
E-mail: info@overdoseday.com
Web: www.overdoseday.com

SMMGP NOTE:

On a related note, you may also be interested in SMMGP's free-to-access e-learning module "Naloxone Saves Lives". The course provides education about naloxone and supports the distribution of naloxone to all who need it by including sections on how to use naloxone; who should be prescribed the medication, training, and what information people need in order to be prescribed naloxone.

The module takes an hour to complete, and includes personal stories and interactive quizzes. It features a handy "Guide to Setting Up a Naloxone Programme in Your Area in 12 Easy Steps". A Certificate of Completion is provided for those who finish the course (suitable for CPD purposes).

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Alcohol Health Alliance (AHA) Day of Action on Alcohol Harms

(Posted 20 August 2014)
One person is killed every single hour by alcohol. Each of those people is a loved one - a parent, a brother or a sister, a friend and tragically, often a child. Annually 1.2 million people are admitted to hospital due to alcohol related causes and countless others see their health damaged because of it. The impact of alcohol all to often affects innocent bystanders through its role in child abuse and neglect, domestic violence, family breakdown and crime and disorder. It tears apart families and damages entire communities and as well as the human toll, it costs the British economy £21 billion every year.

The Alcohol Health Alliance (AHA) is holding a national day of action on the 5th September to draw attention to alcohol related harm in the UK. They want politicians to realise how very real the problem is, and to commit to supporting measures to reduce levels of alcohol related harm.

Will you contact your MP to highlight the levels of alcohol related harm in your local area?

If you have 2 minutes: Join the AHA Thunderclap

Thunderclap is the first-ever crowdspeaking platform that helps people be heard by saying something together. It allows a single message to be mass-shared, flash mob-style, so it rises above the noise of your social networks. By boosting the signal at the same time, Thunderclap helps a single person create action and change like never before.

If you sign up, at 1.30pm on Friday 5th September, a message will be sent from your Twitter/Facebook account reading: "Every single hour, one person in the UK is killed by alcohol. E-mail your MP and demand action now #21billion http://thndr.it/U6x7mI". The tool will access your account only once and will not store or share any of your personal details.

If you have 20 minutes: Write to your MP

If you are unable to meet with your MP in person, you can always write to them. AHA have a template letter available on the above link which you can personalise and send to your MP on the 5th, either by e-mail or by post to their constituency office. They can also supply a hard copy of "Health First: An evidence based alcohol strategy for the UK" by post if you would like to pass this document onto your MP.

You can find out who your MP is and the contact details for their local constituency office at www.findyourmp.parliament.uk or by calling 020 7219 4272 and quoting your postcode.

If you have 60 minutes: Meet with your MP

The most effective way to gain a commitment from your MP to support measures to effectively reduce alcohol related harm in your local area is to meet with them face to face.

If you work in a hospital, as a police officer, in a treatment service or somewhere else where you see directly the impacts of alcohol misuse, you may wish to invite your MP to visit you. The earlier you contact your MP to organise the visit, the more likely it is that they will be able to attend.

Alternatively, most MPs hold drop in sessions in their local constituencies every Friday - you can find out who your MP is and the contact details for their local constituency office at www.findyourmp.parliament.uk or by calling 020 7219 4272 and quoting your postcode.

If you'd like to discuss any of the above, please contact:

Madeleine Harris Smith
Policy and Advocacy Manager, Alcohol Health Alliance
E-mail: mharrissmith@alcoholconcern.org.uk
Tel: 020 7566 9809 (Direct Line)
Tel: 020 7566 9800 (Reception)
Web: www.21billion.org

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Win a FREE International Recovery Month T-shirt from SMMGP

(Posted 18 August 2014)
Making recovery visible in Recovery Month you'll sure stay cool this September and all year round with a limited edition International Recovery Month T-shirt. Their unique mandala style looks great on any occasion. With each T-shirt, individually made with love by someone working on their recovery, you'll also be supporting a great cause.

SMMGP has 16 International Recovery Month T-shirts to give away in a prize draw.
For your chance to win just follow these 2 simple instructions:

  1. Become an SMMGP Member (if you're not already).
    You can join online for free here.
  2. Send an e-mail to admin@smmgp.org.uk with "T-shirt prize draw" in the subject line.
    Please state in the e-mail whether you would like a Medium or Large T-shirt.

    Win a FREE International Recovery Month T-shirt from SMMGP

Closing date for entries is Monday 8 September 2014

Winners will be drawn at random from all correctly submitted entries.

Free entry to the Recovery Month Party if you come wearing your T-shirt! See UK Recovery Federation (UKRF) 6th National Conference event for more details.

Get involved and support Recovery Month. Wear your T-shirt with Pride.

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SMMGP Clinical Update #41 - July 2014 now online

(Posted 06 August 2014)
The SMMGP Clinical Update #41 - July 2014 is now available in the SMMGP Clinical & Policy Updates section in both online and downloadable versions.

If you would like to receive these Updates via e-mail as soon as they are released, please join the SMMGP. Membership is completely free, you can join instantly online, and there are lots of benefits - see the Free SMMGP Membership Application page for more details.

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SMMGP Change of Address Notification

(Posted 28 July 2014)
SMMGP is no longer based in Public Health England, Tobacco, Alcohol & Drugs Division in Skipton House due to a change in our funding arrangements. We are grateful for the support that we have had from PHE for the past year, and we look forward to continuing our mutually advantageous relationship. Everything else remains the same but our contact details have changed:

SMMGP membership is FREE and open to everyone. Our members include GPs, psychiatrists, psychologists, non-medical prescribers, drugs workers and service users. We have over 6,500 members and continue to grow. Registered online forum user numbers exceed 1,250.

We have had an extremely busy and successful year so far and we look forward to a productive future as we continue to champion and support primary care based alcohol and drug treatment by offering advice, support, training, external supervision and appraisal and by being the voice of our members.

Full SMMGP contact details are available here.

For more information about SMMGP's Training and Advisory services, see our SMMGP Advisory Services section.

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New PHE document on NMP in the management of substance misuse now available

(Posted 23 July 2014)
The new PHE document on NMP in the management of substance misuse has now been published.

"Non-medical prescribing (NMP) - namely, the prescribing of medicines by health professionals who are not doctors - allows for increased availability and responsiveness of prescribing interventions. The non-medical management of substance misuse was revolutionised by 2012's change to allow non-media prescribers to independently prescribe for the treatment of drug dependence.

PHE's new document, which replaces a 2007 NTA publication, is intended for non-medical prescribers and all those with an interest in NMP including aspiring non-medical prescribers, consultants and clinical leads, service managers, NMP leads, colleagues from different professions (e.g., doctors, psychologists, and social workers) and service commissioners.

"Non-medical prescribing in the management of substance misuse" was prepared by an expert group convened by PHE alcohol, drugs and tobacco and the National Substance Misuse Non-Medical Prescribing Forum (NSMNMPF). The document defines clear parameters within which non-medical prescribing can be delivered safely and effectively within recovery-orientated drug and alcohol treatment systems."

PHE

The document is available (in Adobe Acrobat PDF format) from the Guidance Documents section:

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Benzodiazepine Guidance now online

(Posted 21 July 2014)
This long awaited 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.

"It has been a long, often difficult and winding road to get to the point of this guidance seeing the light of day. It is perhaps unsurprising because benzodiazepines are probably the drugs that cause more disagreement between different health professionals and different users and also between these groups. Moreover, there are very large holes in the evidence base - which were even bigger at the time of more common use 30 years ago - when benzodiazepines were found to work well in the short term and offered a "quick fix" for some patients.

In October 2005 I co-wrote and released a brief paper "Guidance on prescribing benzodiazepines to drug users in primary care". It was very well received in the UK and internationally. Requests poured in asking us to extend the guidance to all patients in general practice, as benzodiazepines were causing (and still cause) many headaches to both prescribers and users.

A working party was formed to take on the task of expanding the scope of the guidance in late 2006. But as many of you will know - writing coherent guidance by committee is virtually impossible! Many drafts were circulated but differences in style and lack of consensus dragged matters out. More and more time elapsed between each draft, the guidance got longer and more repetitive. Also, negative interest from some groups who felt they were misrepresented in the guidance diverted our attention and for a while we lost focus.

A new way forward was found and after a complete re-write in 2010 Fergus Law and I had a working draft that could be shared. Slowly over the next 3 years we continued to work on the guidance. Because it is such a difficult area, many compromises have had to be made. Where there is no - or conflicting - evidence we have had to use clinical experience.

Many wonderful people have helped us on the way, some acknowledged, others not wanting to be acknowledged. We have tried for the past year to have the guidance endorsed by various bodies but so far we have not been successful. In the meanwhile, once again many people have asked for copies, which we have provided. It has been well received overall, so rather than let it go out of date at this stage we have decided to make it available on the internet. You may not agree with it all, but we hope you find it helpful."

Dr Chris Ford

The guidance is available (in Adobe Acrobat PDF format) from the Guidance Documents section:

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SMMGP Policy Update #38 - June 2014 now online

(Posted 26 June 2014)
The SMMGP Policy Update #38 - June 2014 is now available in the SMMGP Clinical & Policy Updates section in both online and downloadable versions.

If you would like to receive these Updates via e-mail as soon as they are released, please join the SMMGP. Membership is completely free, you can join instantly online, and there are lots of benefits - see the Free SMMGP Membership Application page for more details.

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RCGP SMAH Factsheets: Prescription and Over-the-Counter Medicines Misuse and Dependence

(Posted 10 June 2014)
RCGP Substance Misuse and Associated Health (SMAH) have produced a series of factsheets on addiction to medications, specifically for GPs. They break down the key points into manageable bite-size chunks of learning covering prescription and over-the-counter medicines misuse and dependence; prevention; identification; and treatment.

"I am delighted and proud to be able to launch the first ever educational factsheet series from RCGP SMAH we have a chosen a really important topic area as the subject for this series of factsheets that of addiction to medications. We know because our patients and carers tell us that there is a potential for some patient's getting into difficulty with certain medicines that are prescribed or available to them over the counter. These patients are often vulnerable or have other clinical risk factors. At SMAH we have recognised this as an issue and have been working closely with experts in Public Health England, SMMGP and pain specialists in order to pull together some key learning points. Broken down into bit sized chunks of learning and informed by the current evidence base and what we know of the extent of the problem of addiction to medications these factsheets are designed to be used in clinical day to day practice to inform clinicians, encourage discussion and debate amongst colleagues and to be used as a contribution to personal learning plans/CPD credits."

Dr Linda Harris, BSc MB BS Dip AGP
SMAH Medical Director

The factsheets are available (in Adobe Acrobat PDF format) from the Guidance Documents section.

The factsheets can also be found on the RCGP SMAH web site.

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The Role of Addiction Specialist Doctors in Recovery Orientated Treatment Systems

(Posted 09 June 2014)
A new resource for commissioners, providers and clinicians entitled "The Role of Addiction Specialist Doctors in Recovery Orientated Treatment Systems" is now available (in Adobe Acrobat PDF format) from the Guidance Documents section.

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.

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SMMGP Launches New e-Learning Module: "Naloxone Saves Lives"

(Posted 21 May 2014)
SMMGP introduces a new e-learning section on our website with the launch of a free-to-access module "Naloxone Saves Lives" developed by Kevin Ratcliffe, Consultant Pharmacist in substance misuse. Kevin is the non-medical prescribing lead for the addictions team within Birmingham & Solihull Mental Health Foundation Trust. He developed and implemented the Trust's take-home naloxone programme and is a passionate advocate for the national roll-out of this life-saving medication.

Steve Brinksman, SMMGP Clinical lead says "We are delighted to provide this free online course and we are confident that anyone who completes the training will have the knowledge and assurance to champion the use of naloxone, and local implementation".

The course provides education about naloxone and supports the distribution of naloxone to all who need it by including sections on how to use naloxone; who should be prescribed the medication, training, and what information people need in order to be prescribed naloxone.

The module takes an hour to complete, and includes personal stories and interactive quizzes. It features a handy "Guide to Setting Up a Naloxone Programme in Your Area in 12 Easy Steps" written by Dr Judith Yates, well-known naloxone champion and Birmingham GP.

A Certificate of Completion is provided for those who finish the course (suitable for CPD purposes). Whilst this course is not intended to replace local training on naloxone, it would be a useful introduction or a refresher for those who have already been trained.

For more information about the course, visit www.smmgp-elearning.org.uk

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SMMGP Clinical Update #40 - May 2014 now online

(Posted 09 May 2014)
The SMMGP Clinical Update #40 - May 2014 is now available in the SMMGP Clinical & Policy Updates section in both online and downloadable versions.

If you would like to receive these Updates via e-mail as soon as they are released, please join the SMMGP. Membership is completely free, you can join instantly online, and there are lots of benefits - see the Free SMMGP Membership Application page for more details.

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Adfam Report: "Medications in Drug Treatment - Tackling the Risks to Children"

(Posted 30 April 2014)
A new report from the charity Adfam calls for co-ordinated national action to better safeguard children.

The report calls for:

See the full report on the Adfam web site...

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Cultural Shifts - Black and Minority Ethnic (BME) Drug Use in the UK

(Posted 24 April 2014)
Stereotypes of Asian substance use probably assume heroin to be the main problem drug. But is this an outdated view? Max Daly speaks to those on the frontline in the following article (in Adobe Acrobat PDF format) from Druglink (March/April 2014, 26-2).

Max Daly is co-author of "Narcomania: How Britain Got Hooked on Drugs".

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SMMGP Snap Survey: What is going on with primary care based treatment in your area?

(Posted 17 April 2014)
There has been a steady trickle of comments on our online forums regarding the state of primary care based treatment in certain areas of the UK.

In order to provide our service to the best of our abilities, and advocate nationally for best practice in primary care treatment for people who use drugs and/or alcohol problematically, we need to know what is going on.

SMMGP may be able to provide targeted support for primary care based drug treatment in local areas, if we have the information we need.

Please let us hear your thoughts and comments...

NOTE: All responses are collected anonymously.

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World Report: Doctors Criticise UN's Approach to Global Drugs Control

(Posted 03 April 2014)
A high-level UN meeting on international drug policy came to a close last week with doctors lamenting the lack of progress on health issues. Ed Holt reports from Vienna in the following article (in Adobe Acrobat PDF format) from The Lancet Vol 383 March 29, 2014 (www.thelancet.com).

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SMMGP Policy Update #37 - March 2014 now online

(Posted 25 March 2014)
The SMMGP Policy Update #37 - March 2014 is now available in the SMMGP Clinical & Policy Updates section in both online and downloadable versions.

If you would like to receive these Updates via e-mail as soon as they are released, please join the SMMGP. Membership is completely free, you can join instantly online, and there are lots of benefits - see the Free SMMGP Membership Application page for more details.

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Physicians demand global drug policy reform in UN meeting (Vienna, 17-Mar-2014).

(Posted 18 March 2014)
More than 5 billion people, 83% of the world's population, mostly in the lower and middle income countries, have low or no access to medicines such as morphine and methadone that are tightly controlled under international treaty law. Physicians around the world who have had enough of watching their patients suffer and die in severe pain are finally speaking out. They are now calling on the Commission on Narcotic Drugs (CND), the UN agency responsible for drug control, to demand better access to pain medicines for their patients.

For the first time, some CND member states are joining with international physician organisations and UN agencies to support this cause. Delegates from Australia, Switzerland, and India highlighted the "tragedy" of inadequate access to essential medicines in their national statements at the plenary session of the CND High Level Review of the world drug problem.

Switzerland said "we need to recognise their suffering as an unintended and unacceptable side-effect of drug control" and Australia cited the "moral imperative" of ensuring that all doctors be able to access medicines for their patients needing pain relief and opioid substitution therapy.

Over-emphasising enforcement and punishment of drug use rather than public health, drives the HIV and Hepatitis C epidemics while leaving millions of cancer and AIDS patients to suffer severe pain.

According to Dr. Judith Yates, Chair of the Board of International Doctors for Healthier Drug Policies, "We have a problem of inadequate access to opioid medicines in a significant number of lower income countries. This compromises medical ethics, which requires us, to cure sometimes, to relieve often, to comfort always. Physicians without access to essential medicines can't do that. We call on UN agencies to focus on supporting low income countries in order to ensure proper access to drugs for medicinal purposes".

Contacts

More Resources

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IDHDP - Attention all doctors!

(Posted 13 March 2014)
March 2016 will see the first UN General Assembly Special Session (UNGASS) on the World Drug Problem since 1998. Leading up to this there will be many opportunities to move health high up on the agenda. International Doctors for Healthier Drug Policies (IDHDP) would like your help to ensure that it is.

Please visit the IDHDP web site to find out how you can help.

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SMMGP Clinical Update #39 - March 2014 now online

(Posted 24 February 2014)
The SMMGP Clinical Update #39 - March 2014 is now available in the SMMGP Clinical & Policy Updates section in both online and downloadable versions.

If you would like to receive these Updates via e-mail as soon as they are released, please join the SMMGP. Membership is completely free, you can join instantly online, and there are lots of benefits - see the Free SMMGP Membership Application page for more details.

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Network #36 now online

(Posted 18 February 2014)
Issue 36 of "Network", the SMMGP Newsletter, is now available to read online, download in Adobe Acrobat PDF format, or browse as a "digital publication" from the Newsletters section in the Resource Library.

For the first time we are bringing Network Newsletter to you in an online format only without a paper copy. For almost 18 years we have provided Network free of charge to anyone who has asked, and we have never used advertising. In the past we have funded the paper copy of network via educational grants but the period of austerity has meant that this has become more difficult.

We know that some people prefer online formats, which include standard web pages, downloadable PDFs and digital publication versions. However, we know that it's difficult to beat the ease-of-reading and convenience of a printed copy. We would like to provide printed copies of future Network editions, but cannot guarantee this at present. We want to continue to provide Network for free. We would also like to avoid having to fill Network with pages of advertising.

So... we would like to ask for help from our readers. If you feel that Network is useful to you now or has been in the past, please consider donating a small amount to help us continue to provide it.

Donations can easily be made via the "Donate to SMMGP" button found at the foot of every web page on our website. Alternatively, please contact us for other ways to pledge support. Please also contribute to the SMMGP Forums or contact us to let us know of your views about us changing to an electronic format.

If you would like to receive copies of Network via post and/or e-mail as soon as they are released, please join the SMMGP. Membership is completely free, you can join instantly online, and there are lots of benefits - see the Free SMMGP Membership Application page for more details.

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Would a Professional Association be beneficial to the Alcohol & Drugs Workforce?

(Posted 5 February 2014)
Skills for Justice is conducting research on the demand for and potential benefits of a Professional Association dedicated to the Alcohol & Drugs Sector. Your opinion would be invaluable to help to assess whether setting up a Professional Association could be valuable to you and the Alcohol & Drugs Sector.

The survey aims to explore...

Following up on previous research on the needs and potential benefits of a Voluntary Professional Register for the Alcohol & Drugs Workforce, research findings highlighted that developing a Professional Association may be the most appropriate long-term instrument to address the challenges faced by the Alcohol & Drugs Workforce. The survey aims to explore this potential solution. Furthermore, establishing a Professional Association could lead to the future development of a high profile and impactful Voluntary Professional Register.

The survey should take you no more than 15 minutes to complete, and can be found via the following link...

Complete the online survey here!

The survey will close on 17 February 2014.

Skills for Justice would welcome the views of those involved in the Alcohol & Drugs Sector such as workers and other professionals, students, volunteers, teachers, policy-makers and commissioners of services.

If you have any difficulties, or would like further details about the work, please contact Sophia Verhaeghe by e-mail at Sophia.verhaeghe@sfjukor by phone on 0114 231 7399.

Thank you for your support.

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Blenheim Community Drug Project - 50 Recovery Stories

(Posted 15 January 2014)
Blenheim CDP is a charity that provides support services for drug and alcohol users, families and carers.

It is celebrating 50 years of social action this year and as part of this they are publishing 50 stories of people's recovery. A new story will be released every Monday at www.blenheim50.wordpress.com by picture, text, audio and video.

Please sign up to their blog or follow them on Twitter to receive notifications of these inspirational journeys of recovery.